Provider Demographics
NPI:1508941196
Name:WOOD, RICHARD HENRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HENRY
Last Name:WOOD
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 1:4440 SPRINGFIELD RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3410
Mailing Address - Country:US
Mailing Address - Phone:804-747-9511
Mailing Address - Fax:804-762-8930
Practice Address - Street 1:4440 SPRINGFIELD RD
Practice Address - Street 2:SUITE 104
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3410
Practice Address - Country:US
Practice Address - Phone:804-747-9511
Practice Address - Fax:804-762-8930
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010043261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice