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1508419698
DEREK T RICKSON
LOGAN, UT
NPI
1508419698
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: UT 11773797-9923)
Enumeration Date
2019-07-18
Last Update Date
2020-07-06
Business Address
Dr. DEREK T RICKSON DDS
1451 N 200 E STE 200
LOGAN, UT 84341-7565
Phone number: 435-258-9039
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Mailing Address
Dr. DEREK T RICKSON DDS
542 S 850 E
SMITHFIELD, UT 84335-2549
Phone number: 435-764-8618
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