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Individual

DR. JOHN R RICCI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1252 SMITH ST, PROVIDENCE, RI 02908
(401) 521-3483
Mailing address
7 DARIO DRIVE, LINCOLN, RI 02865
(401) 354-8996

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2137
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14316-1
DENTAL BENIFITS PROVIDER
RI
01
8319-7
RI BLUE CROSS
RI
01
JR00816
RI MEDICAL ASSISTANCE
RI
01
RI 2137
DELTA DENTAL OF RI
RI
Enumeration date
04/18/2007
Last updated
07/08/2007
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