Provider Demographics
NPI:1740402338
Name:BOHN, RICHARD ALAN (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALAN
Last Name:BOHN
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 1:307 N CHESTNUT ST.
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17087-0647
Mailing Address - Country:US
Mailing Address - Phone:717-866-5600
Mailing Address - Fax:717-866-7679
Practice Address - Street 1:307 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:PA
Practice Address - Zip Code:17087-0647
Practice Address - Country:US
Practice Address - Phone:717-866-5600
Practice Address - Fax:717-866-7679
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
PADS15327122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist