Provider Demographics
NPI:1861483133
Name:RICHMAN, ANDREA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:RICHMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 576
Mailing Address - Street 2:18 WESTFORD ROAD
Mailing Address - City:CARLISLE
Mailing Address - State:MA
Mailing Address - Zip Code:01741-0576
Mailing Address - Country:US
Mailing Address - Phone:978-369-7967
Mailing Address - Fax:978-369-1086
Practice Address - Street 1:18 WESTFORD ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:MA
Practice Address - Zip Code:01741-1506
Practice Address - Country:US
Practice Address - Phone:978-369-7967
Practice Address - Fax:978-369-1086
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13905122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist