Provider Demographics
NPI:1285639864
Name:RICHTER, RICHARD P (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:RICHTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 E KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1440
Mailing Address - Country:US
Mailing Address - Phone:732-367-7171
Mailing Address - Fax:732-370-4966
Practice Address - Street 1:604 E KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1440
Practice Address - Country:US
Practice Address - Phone:732-367-7171
Practice Address - Fax:732-370-4966
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ91791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2857006Medicaid