Provider Demographics
NPI:1073658456
Name:STUART, RICHARD J JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:STUART
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:8218 TWIN POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-8896
Mailing Address - Country:US
Mailing Address - Phone:317-846-0509
Mailing Address - Fax:317-574-5039
Practice Address - Street 1:3021 E 98TH ST
Practice Address - Street 2:SUITE 240
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-2938
Practice Address - Country:US
Practice Address - Phone:317-846-0509
Practice Address - Fax:317-574-5039
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN82651223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics