Individual
DR. MATTHEW D FICCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MSD
Contact information
Practice address
3325 SPRINGBANK LN, SUITE 140, CHARLOTTE, NC 28226-3365
(704) 544-2224
(704) 544-2259
Mailing address
3325 SPRINGBANK LN, SUITE 140, CHARLOTTE, NC 28226-3365
(704) 544-2224
(704) 544-2259
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401410412
VA
1223P0300X
Periodontics
Primary
7216
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9182627
—
VA
Enumeration date
05/30/2007
Last updated
03/07/2008
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