Provider Demographics
NPI:1962683912
Name:RICHARD A PEYSER DDS PC
Entity Type:Organization
Organization Name:RICHARD A PEYSER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:PEYSER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-893-3333
Mailing Address - Street 1:2251 PIMMIT DR
Mailing Address - Street 2:C4
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2811
Mailing Address - Country:US
Mailing Address - Phone:703-893-3333
Mailing Address - Fax:703-288-4333
Practice Address - Street 1:2251 PIMMIT DR
Practice Address - Street 2:C4
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2811
Practice Address - Country:US
Practice Address - Phone:703-893-3333
Practice Address - Fax:703-288-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010043531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty