Provider Demographics
NPI:1083823918
Name:AUTORI, RICO FRANCIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICO
Middle Name:FRANCIS
Last Name:AUTORI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GRAPEVINE RD
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2530
Mailing Address - Country:US
Mailing Address - Phone:978-750-4449
Mailing Address - Fax:978-750-8886
Practice Address - Street 1:5 GRAPEVINE RD
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2530
Practice Address - Country:US
Practice Address - Phone:978-750-4449
Practice Address - Fax:978-750-8886
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1228420207LP3000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAT87764Medicare UPIN