Provider Demographics
NPI:1568646313
Name:SANCHEZ, RICARDO MANLUCU (DDS)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:MANLUCU
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2386 JUNIPERO SERRA BLVD
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1647
Mailing Address - Country:US
Mailing Address - Phone:650-994-3836
Mailing Address - Fax:
Practice Address - Street 1:2386 JUNIPERO SERRA BLVD
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1647
Practice Address - Country:US
Practice Address - Phone:650-994-3836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55213122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist