Provider Demographics
NPI:1568674794
Name:NADEAU, RICHARD DEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DEE
Last Name:NADEAU
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 1:1994 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-5856
Mailing Address - Country:US
Mailing Address - Phone:612-625-5955
Mailing Address - Fax:612-626-6096
Practice Address - Street 1:1994 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-5856
Practice Address - Country:US
Practice Address - Phone:612-625-5955
Practice Address - Fax:612-626-6096
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10368122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist