Provider Demographics
NPI:1538493317
Name:RICHARD A. LOOK, D.D.S., INC.
Entity Type:Organization
Organization Name:RICHARD A. LOOK, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-241-6374
Mailing Address - Street 1:2710 EUREKA WAY STE 3
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0230
Mailing Address - Country:US
Mailing Address - Phone:530-241-6374
Mailing Address - Fax:530-241-5140
Practice Address - Street 1:2710 EUREKA WAY STE 3
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0230
Practice Address - Country:US
Practice Address - Phone:530-241-6374
Practice Address - Fax:530-241-5140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA228171223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty