Provider Demographics
NPI:1922325943
Name:HOMPESCH, RICHARD WILLIAM III (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:HOMPESCH
Suffix:III
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 1:119 N CUSHMAN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-2879
Mailing Address - Country:US
Mailing Address - Phone:907-978-1535
Mailing Address - Fax:
Practice Address - Street 1:2009 COWLES ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5916
Practice Address - Country:US
Practice Address - Phone:907-374-8111
Practice Address - Fax:907-374-8119
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1055421223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery