Provider Demographics
NPI:1093705618
Name:HULL, RICHARD RAYMOND (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:RAYMOND
Last Name:HULL
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 1:650 N LEE HWY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-3759
Mailing Address - Country:US
Mailing Address - Phone:540-463-5241
Mailing Address - Fax:540-463-4819
Practice Address - Street 1:650 N LEE HWY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3759
Practice Address - Country:US
Practice Address - Phone:540-463-5241
Practice Address - Fax:540-463-4819
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010057081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice