Provider Demographics
NPI:1780831487
Name:RICHMAN, MATTHEW B (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:B
Last Name:RICHMAN
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 1:2300 WAYNE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1726
Mailing Address - Country:US
Mailing Address - Phone:919-581-9770
Mailing Address - Fax:919-581-9771
Practice Address - Street 1:2300 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1726
Practice Address - Country:US
Practice Address - Phone:919-581-9770
Practice Address - Fax:919-581-9771
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ81831223S0112X
NC104741223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program