Jeremiah Ricketson Valid NPI

Individual provider · Oral and Maxillofacial Surgery (Dentist) · West Hartford, CT

NPI

1659933620

Type

Individual (Type 1)

Primary specialty

Oral and Maxillofacial Surgery (Dentist) (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223S0112X

License number

2.013969 (CT)

Sex

Male

Sole proprietor

No

Enumerated

2019-07-01

Last updated

2025-06-26