| Edward L Rick Dds,ms,pc | |
|
6926 N University St Ste C Peoria IL 61614-1728 | |
| (309) 692-5863 | |
| (309) 689-3031 |
| Full Name | Edward L Rick Dds,ms,pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6926 N University St Ste C, Peoria, Illinois |
| Authorized Official Name and Position | Kimberly A Hoskins (RECEPTIONIST) |
| Authorized Official Contact | 3096825863 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward L Rick Dds,ms,pc 6926 N University St Ste C Peoria IL 61614-1728 Ph: (309) 692-5863 | Edward L Rick Dds,ms,pc 6926 N University St Ste C Peoria IL 61614-1728 Ph: (309) 692-5863 |
| NPI Number | 1588818736 |
|---|---|
| Provider Enumeration Date | 11/13/2008 |
| Last Update Date | 11/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588818736 | NPI | - | NPPES |
| 1003466/101355 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 021-000885 (Illinois) | Primary |
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