Provider Demographics
NPI:1093846099
Name:GAW, RICHARD A (DDS, PLLC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:GAW
Suffix:
Gender:M
Credentials:DDS, PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 STURBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-5300
Mailing Address - Country:US
Mailing Address - Phone:615-661-8958
Mailing Address - Fax:
Practice Address - Street 1:3817 BEDFORD AVE.
Practice Address - Street 2:SUITE 110
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215
Practice Address - Country:US
Practice Address - Phone:615-298-5948
Practice Address - Fax:615-298-5719
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN69381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice