Provider Demographics
NPI:1114938941
Name:FORBES, RICHARD MCKINNON (DMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:MCKINNON
Last Name:FORBES
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 1:516 NEW MARKET BLVD
Mailing Address - Street 2:STE 2
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607
Mailing Address - Country:US
Mailing Address - Phone:828-265-4867
Mailing Address - Fax:828-262-9686
Practice Address - Street 1:516 NEW MARKET BLVD
Practice Address - Street 2:STE 2
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607
Practice Address - Country:US
Practice Address - Phone:828-265-4867
Practice Address - Fax:828-262-9686
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC57061223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics