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Individual

DR. JOSHUA RICCIARDONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
5300 OVERLOOK RD, MOBILE, AL 36618-2331
(251) 342-6672
(251) 342-6703
Mailing address
5300 OVERLOOK RD, MOBILE, AL 36618-2331
(251) 342-6672
(337) 886-6348

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
6200
LA
1223G0001X
General Practice Dentistry
Primary
6351
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1862002
LA
Enumeration date
07/02/2011
Last updated
11/06/2018
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