Provider Demographics
NPI:1346692787
Name:RICHER, JUSTIN PEIRCE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:PEIRCE
Last Name:RICHER
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:PO BOX 8880
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-0015
Mailing Address - Country:US
Mailing Address - Phone:479-582-3000
Mailing Address - Fax:479-582-2840
Practice Address - Street 1:3996 N FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5122
Practice Address - Country:US
Practice Address - Phone:479-582-3002
Practice Address - Fax:479-582-2840
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DR03038122300000X, 1223S0112X
AR44221223S0112X, 204E00000X
NJ069211223S0112X, 204E00000X
NJ22D1026628001223S0112X
NJ22D1026628011223S0112X
NJ22D1026628021223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No122300000XDental ProvidersDentist
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery