Individual
DR. NICHOLAS VERTUCCI RICCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3332 ROCHAMBEAU AVE, BRONX, NY 10467-2836
(718) 920-5997
Mailing address
603 PRAIRIE AVE, GLEN ELLYN, IL 60137-4033
(630) 805-2175
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021002755
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/24/2013
Last updated
06/06/2017
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