Provider Demographics
NPI:1740427905
Name:RICHMOND HILL FAMILY & COSMETIC DENTISTRY
Entity Type:Organization
Organization Name:RICHMOND HILL FAMILY & COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:DORITY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:912-756-3380
Mailing Address - Street 1:10015 FORD AVE
Mailing Address - Street 2:2-A ST. JOSEPH MEDICAL PLAZA
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-8804
Mailing Address - Country:US
Mailing Address - Phone:912-756-3880
Mailing Address - Fax:912-756-3516
Practice Address - Street 1:10015 FORD AVE
Practice Address - Street 2:2-A ST. JOSEPH MEDICAL PLAZA
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-8804
Practice Address - Country:US
Practice Address - Phone:912-756-3880
Practice Address - Fax:912-756-3516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012438122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty