Provider Demographics
NPI:1679619977
Name:RICCI, TERRENCE ARMAND (DDS)
Entity type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:ARMAND
Last Name:RICCI
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 1:431 W OAKDALE AVE
Mailing Address - Street 2:13C
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5995
Mailing Address - Country:US
Mailing Address - Phone:773-477-2127
Mailing Address - Fax:
Practice Address - Street 1:7407 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-2139
Practice Address - Country:US
Practice Address - Phone:773-625-2626
Practice Address - Fax:773-625-4071
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist