Provider Demographics
NPI:1376699652
Name:RICCI, STEVE (DDS, MS)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:RICCI
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 1:10475 MEDLOCK BRIDGE RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4433
Mailing Address - Country:US
Mailing Address - Phone:678-417-9848
Mailing Address - Fax:678-417-9694
Practice Address - Street 1:10475 MEDLOCK BRIDGE RD
Practice Address - Street 2:SUITE 114
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-4433
Practice Address - Country:US
Practice Address - Phone:678-417-9848
Practice Address - Fax:678-417-9694
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA119081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics