Provider Demographics
NPI:1093031593
Name:CAPLES, RICKY G (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:RICKY
Middle Name:G
Last Name:CAPLES
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 FORSYTHE AVENUE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3613
Mailing Address - Country:US
Mailing Address - Phone:318-325-9655
Mailing Address - Fax:
Practice Address - Street 1:2210 FORSYTHE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3613
Practice Address - Country:US
Practice Address - Phone:318-325-9655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA44091223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics