Provider Demographics
NPI:1508931585
Name:CAUDILL, RICHARD FRANKLIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FRANKLIN
Last Name:CAUDILL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:CAUDILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD PA
Mailing Address - Street 1:395 C TEQUESTA DRIVE
Mailing Address - Street 2:
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469-3086
Mailing Address - Country:US
Mailing Address - Phone:561-743-7286
Mailing Address - Fax:561-743-7886
Practice Address - Street 1:395 C TEQUESTA DRIVE
Practice Address - Street 2:
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469-3086
Practice Address - Country:US
Practice Address - Phone:561-743-7286
Practice Address - Fax:561-743-7886
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN6312122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist