Provider Demographics
NPI:1649003278
Name:LOUIS J. TRICERRI, DDS, FAGD
Entity type:Organization
Organization Name:LOUIS J. TRICERRI, DDS, FAGD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TRICERRI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,FAGD
Authorized Official - Phone:530-885-8152
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:
Practice Address - Street 1:3113 PROFESSIONAL DR STE 3
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2459
Practice Address - Country:US
Practice Address - Phone:530-885-8152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty