Provider Demographics
NPI:1518106319
Name:TOOKE, RICHARD JUSTIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JUSTIN
Last Name:TOOKE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11398 SE 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-7637
Mailing Address - Country:US
Mailing Address - Phone:503-957-0370
Mailing Address - Fax:
Practice Address - Street 1:11398 SE 82ND AVE
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-7637
Practice Address - Country:US
Practice Address - Phone:503-231-8228
Practice Address - Fax:503-231-5634
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD90961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice