Provider Demographics
NPI:1851567945
Name:RICHARD B. DAWSON D.D.S. INC.
Entity Type:Organization
Organization Name:RICHARD B. DAWSON D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:707-448-6868
Mailing Address - Street 1:619 BUCK AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-3511
Mailing Address - Country:US
Mailing Address - Phone:707-448-6868
Mailing Address - Fax:707-448-6825
Practice Address - Street 1:619 BUCK AVE
Practice Address - Street 2:SUITE C
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-3511
Practice Address - Country:US
Practice Address - Phone:707-448-6868
Practice Address - Fax:707-448-6825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24376261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental