Provider Demographics
NPI:1962686949
Name:REICHMAN, RICHARD DENNIS (DDS, FICCMO, FACMS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DENNIS
Last Name:REICHMAN
Suffix:
Gender:M
Credentials:DDS, FICCMO, FACMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 NORTHBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-4908
Mailing Address - Country:US
Mailing Address - Phone:404-934-2294
Mailing Address - Fax:
Practice Address - Street 1:6063 PEACHTREE PKWY
Practice Address - Street 2:SUITE 201B
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-3303
Practice Address - Country:US
Practice Address - Phone:404-934-2294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA90931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice