Provider Demographics
NPI:1255382032
Name:VALENTINE, RICARDO A (DDS)
Entity type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:A
Last Name:VALENTINE
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 1:1815 PRAIRIE CITY ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630
Mailing Address - Country:US
Mailing Address - Phone:916-985-7100
Mailing Address - Fax:916-985-9588
Practice Address - Street 1:1815 PRAIRIE CITY ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630
Practice Address - Country:US
Practice Address - Phone:916-985-7100
Practice Address - Fax:916-985-9588
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA340752122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist