Provider Demographics
NPI:1093921140
Name:PENMAN, RICHARD ALLAN II (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALLAN
Last Name:PENMAN
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:570 LAGUNA DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1607
Mailing Address - Country:US
Mailing Address - Phone:760-434-7374
Mailing Address - Fax:760-434-1605
Practice Address - Street 1:570 LAGUNA DR
Practice Address - Street 2:SUITE A
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1607
Practice Address - Country:US
Practice Address - Phone:760-434-7374
Practice Address - Fax:760-434-1605
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA440561223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry