Individual
RYAN JELICICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2009 8TH ST NW APT 303, WASHINGTON, DC 20001-5751
(916) 605-9147
Mailing address
2009 8TH ST NW APT 303, WASHINGTON, DC 20001-5751
(916) 605-9147
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
27792
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2022
Last updated
04/12/2023
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