Provider Demographics
NPI:1033270152
Name:CHARMOY, RICHARD PETER (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PETER
Last Name:CHARMOY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1809
Mailing Address - Country:US
Mailing Address - Phone:908-722-9222
Mailing Address - Fax:908-231-0334
Practice Address - Street 1:78 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1809
Practice Address - Country:US
Practice Address - Phone:908-722-9222
Practice Address - Fax:908-231-0334
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI151601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ562466306OtherTIN