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General NPI Number Information
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NPI Number | 1629515820
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Entity Type | Individual
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Provider Name | CHRISTOPHER MARK RICKER D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 10 MEDICAL PARK DENTAL DEPARTMENT
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City | COLUMBIA
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State | SC
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Zip | 29203
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Country | US
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Telephone | 803-434-6567
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Fax | 803-434-6299
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Provider Business Mailing Address
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Address Line | 9920 KINCEY AVE STE 280
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-2400
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Country | US
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Telephone | 704-322-3000
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Fax | 704-755-6533
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 10739
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License Number State | NC
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