Provider Demographics
NPI:1861613721
Name:MACASAET, RICARDO M (DDS)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:M
Last Name:MACASAET
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 1:8457 ELK GROVE FLORIN RD STE 130
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-9564
Mailing Address - Country:US
Mailing Address - Phone:916-681-8899
Mailing Address - Fax:916-681-8890
Practice Address - Street 1:8457 ELK GROVE FLORIN RD STE 130
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-9564
Practice Address - Country:US
Practice Address - Phone:916-681-8899
Practice Address - Fax:916-681-8890
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0371341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice