Provider Demographics
NPI:1841219425
Name:DICKARD, RICHARD JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:DICKARD
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 1:216 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-2720
Mailing Address - Country:US
Mailing Address - Phone:530-265-8011
Mailing Address - Fax:530-265-8737
Practice Address - Street 1:216 S PINE ST
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2720
Practice Address - Country:US
Practice Address - Phone:530-265-8011
Practice Address - Fax:530-265-8737
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA246501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice