Provider Demographics
NPI:1437160892
Name:WAGHALTER, RICHARD BARRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BARRY
Last Name:WAGHALTER
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 1:6065 HILLCROFT ST STE 207
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-1005
Mailing Address - Country:US
Mailing Address - Phone:713-771-7101
Mailing Address - Fax:713-771-7102
Practice Address - Street 1:6065 HILLCROFT ST STE 207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-1005
Practice Address - Country:US
Practice Address - Phone:713-771-7101
Practice Address - Fax:713-771-7102
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94041223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics