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General NPI Number Information
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NPI Number | 1144604703
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Entity Type | Individual
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Provider Name | NANCY ALEXANDRA RICCARDI DMD
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Gender | Female
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 204 HUDSON ST
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City | AMERICUS
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State | GA
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Zip | 31709-3338
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Country | US
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Telephone | 229-924-2224
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Fax | 229-924-4452
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Provider Business Mailing Address
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Address Line | PO BOX 336
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City | AMERICUS
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State | GA
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Zip | 31709-0336
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Country | US
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Telephone | 229-924-2224
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Fax | 229-924-4452
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN014963
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License Number State | GA
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