Provider Demographics
NPI:1477768745
Name:DEST, RICHARD F (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:F
Last Name:DEST
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 1:8305 UNIVERSITY EXECUTIVE PARK DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262
Mailing Address - Country:US
Mailing Address - Phone:704-547-1279
Mailing Address - Fax:704-547-8383
Practice Address - Street 1:8305 UNIVERSITY EXECUTIVE PARK DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262
Practice Address - Country:US
Practice Address - Phone:704-547-1279
Practice Address - Fax:704-547-8383
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC52831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice