Provider Demographics
NPI:1326052523
Name:MUMFORD, RICK (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:
Last Name:MUMFORD
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:UNC SCH DENTISTRY MANNING DRIVE & COLUMBIA ST
Mailing Address - Street 2:UNC AT CHAPEL HILL - CBO # 7450
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7450
Mailing Address - Country:US
Mailing Address - Phone:919-966-2787
Mailing Address - Fax:
Practice Address - Street 1:UNC SCH DENTISTRY MANNING DRIVE & COLUMBIA ST
Practice Address - Street 2:UNC AT CHAPEL HILL - CBO # 7450
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7450
Practice Address - Country:US
Practice Address - Phone:919-966-2787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC50371223G0001X
KY53071223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223D0001XDental ProvidersDentistDental Public Health