Individual
PATRICK BRENT RICKHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1145 E POLSTON AVE, POST FALLS, ID 83854-6045
(208) 777-1010
Mailing address
1145 E POLSTON AVE, POST FALLS, ID 83854-6045
(208) 777-1010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901019395
MI
122300000X
Dentist
PRV-ML-001-16
MS
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4901
ID
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
OR-521-16
MS
Other
Enumeration date
09/02/2006
Last updated
06/13/2025
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