Provider Demographics
NPI:1104045129
Name:TRICERRI, LOUIS J (DDS, FAGD)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:J
Last Name:TRICERRI
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3113 PROFESSIONAL DR STE 3
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2459
Mailing Address - Country:US
Mailing Address - Phone:530-885-8152
Mailing Address - Fax:530-885-4923
Practice Address - Street 1:292 ALAMO DR STE 5
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4243
Practice Address - Country:US
Practice Address - Phone:707-448-6882
Practice Address - Fax:707-448-9703
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA326731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice