Provider Demographics
NPI:1497794176
Name:PASCOE, RICHARD L (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:PASCOE
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8865 PROFESSIONAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-8424
Mailing Address - Country:US
Mailing Address - Phone:231-775-6321
Mailing Address - Fax:231-775-0552
Practice Address - Street 1:8865 PROFESSIONAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-8424
Practice Address - Country:US
Practice Address - Phone:231-775-6321
Practice Address - Fax:231-775-0552
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI290100-97781223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics