Provider Demographics
NPI:1386011617
Name:RICHMOND ORTHODONTICS, INC
Entity Type:Organization
Organization Name:RICHMOND ORTHODONTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:G
Authorized Official - Last Name:FRIDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-740-1297
Mailing Address - Street 1:8503 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-6442
Mailing Address - Country:US
Mailing Address - Phone:804-740-1297
Mailing Address - Fax:
Practice Address - Street 1:8503 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-6442
Practice Address - Country:US
Practice Address - Phone:804-740-1297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty