Provider Demographics
NPI:1013114800
Name:MELICHAR, RICHARD PATRICK (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:PATRICK
Last Name:MELICHAR
Suffix:
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 1:8712 GILLESPIE RD
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:MO
Mailing Address - Zip Code:64074-7207
Mailing Address - Country:US
Mailing Address - Phone:816-625-3241
Mailing Address - Fax:816-625-3241
Practice Address - Street 1:8712 GILLESPIE RD
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:MO
Practice Address - Zip Code:64074-7207
Practice Address - Country:US
Practice Address - Phone:816-625-3241
Practice Address - Fax:816-625-3241
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO131331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice