Provider Demographics
NPI:1467791202
Name:CAVANAUGH, RICHARD RAYMOND (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:RAYMOND
Last Name:CAVANAUGH
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 1:800 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-1000
Mailing Address - Country:US
Mailing Address - Phone:215-345-1155
Mailing Address - Fax:215-345-9090
Practice Address - Street 1:800 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-1000
Practice Address - Country:US
Practice Address - Phone:215-345-1155
Practice Address - Fax:215-345-9090
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0163571223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics