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Individual

DR. DEREK T RICKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1451 N 200 E STE 200, LOGAN, UT 84341-7565
(435) 258-9039
(435) 787-1741
Mailing address
542 S 850 E, SMITHFIELD, UT 84335-2549
(435) 764-8618

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11773797-9923
UT

Other

Enumeration date
07/18/2019
Last updated
07/06/2020
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