Provider Demographics
NPI:1669477097
Name:MCLAIN, RICHARD LOUIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LOUIS
Last Name:MCLAIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1808 MOUNTAIN SAGE PL
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-2660
Mailing Address - Country:US
Mailing Address - Phone:303-346-1129
Mailing Address - Fax:
Practice Address - Street 1:7889 S LINCOLN CT
Practice Address - Street 2:STE 201
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2651
Practice Address - Country:US
Practice Address - Phone:303-798-4553
Practice Address - Fax:303-798-2208
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO75901223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82174831Medicaid