Individual
ELIZABETH BLANCA RICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
8475 SPARTA LINE RD NW STE C, SPARTA, MI 49345-8159
(866) 988-4504
Mailing address
611 CROFTON ST SW, GRAND RAPIDS, MI 49503-8029
(616) 710-9409
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902017697
MI
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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