Provider Demographics
NPI:1326128208
Name:THE DENTAL OFFICES OF JARON WEDDING D.D.S., M.S.D., AND RICHARD ORRICK
Entity Type:Organization
Organization Name:THE DENTAL OFFICES OF JARON WEDDING D.D.S., M.S.D., AND RICHARD ORRICK
Other - Org Name:CREVE COEUR ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ORRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:317-994-3737
Mailing Address - Street 1:522 N NEW BALLAS RD STE 382
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6819
Mailing Address - Country:US
Mailing Address - Phone:314-994-3737
Mailing Address - Fax:314-994-3757
Practice Address - Street 1:522 N NEW BALLAS RD STE 382
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6819
Practice Address - Country:US
Practice Address - Phone:314-994-3737
Practice Address - Fax:314-994-3757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20030162281223E0200X
MO20050196351223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty