Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MATTHEW E TICICH, DMD
Active Sole ProprietorDR. MATTHEW E TICICH, DMD is a Endodontics healthcare provider located in FORT CAMPBELL, Kentucky. NPI 1407297484 is currently active in the NPPES registry. Verify at CMS.
Endodontics · FORT CAMPBELL, KY
Registration Details
- NPI Number
- 1407297484
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 8, 2013 (13.073503712789 yrs)
- Last Updated
- Mar 24, 2023
- Licenses
-
DEN.00203425 (CO)31790 (TX)62475 (CA)11869 (TN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6145 DESERT STORM AVEFORT CAMPBELL, KY, 422235558Browse KY providers · Browse ZIP 42223
- Phone
- 9515292070
- Primary Specialty
-
Endodontics
1223E0200X
- Additional Specialty
- General Dentistry
- Additional Specialty
- General Dentistry
- Additional Specialty
- Endodontics
Other Endodontics Providers in FORT CAMPBELL, KY
| Name | Credential | NPI |
|---|---|---|
| DR. JAMES ROBERT CORCORAN | DDS | 1144294562 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.