Individual
DR. CHARLES SHUBERT RICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
136 S ASPEN CT, SUITE B, VISALIA, CA 93291-5175
(559) 625-9300
(559) 625-9330
Mailing address
136 S ASPEN CT, SUITE B, VISALIA, CA 93291-5175
(559) 625-9300
(559) 625-9330
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
23135
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
GA1358
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G93774-01
DENT-CAL
CA
Enumeration date
07/28/2006
Last updated
10/13/2011
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