Provider Demographics
NPI:1083245849
Name:RICHMOND SMILE DESIGN, PLLC
Entity Type:Organization
Organization Name:RICHMOND SMILE DESIGN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:CDPMA
Authorized Official - Phone:859-623-3818
Mailing Address - Street 1:311 RADIO PARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2399
Mailing Address - Country:US
Mailing Address - Phone:859-623-3818
Mailing Address - Fax:859-624-1061
Practice Address - Street 1:311 RADIO PARK DR STE B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2399
Practice Address - Country:US
Practice Address - Phone:859-623-3818
Practice Address - Fax:859-624-1061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty