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Individual

JOHN L RICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2620 48TH AVE W, BRADENTON, FL 34207-1700
(941) 753-1432
Mailing address
2620 48TH AVE W, BRADENTON, FL 34207-1700
(941) 753-1432

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN4857
FL

Other

Enumeration date
09/21/2009
Last updated
09/21/2009
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