Organization
EDWARD L RICK DDS MS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY GAMM (OFFICER MANAGER)
(815) 625-2112
Entity
Organization
Contact information
Practice address
1808 FIRST AVE, STERLING, IL 61081-1202
(815) 625-2112
(815) 625-2143
Mailing address
1808 FIRST AVE, STERLING, IL 61081-1202
(815) 625-2112
(815) 625-2143
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
021-000885
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003466/101354
—
IL
Enumeration date
11/03/2008
Last updated
11/03/2008
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