Provider Demographics
NPI:1295906519
Name:RICHARD LAPP ORAL & MAXILLOFACIAL SURGERY, INC.
Entity type:Organization
Organization Name:RICHARD LAPP ORAL & MAXILLOFACIAL SURGERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-452-2713
Mailing Address - Street 1:1246 ASHLAND AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2861
Mailing Address - Country:US
Mailing Address - Phone:740-452-2713
Mailing Address - Fax:740-452-7395
Practice Address - Street 1:1246 ASHLAND AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2861
Practice Address - Country:US
Practice Address - Phone:740-452-2713
Practice Address - Fax:740-452-7395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300114231223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4972758Medicaid
RI0869901Medicare PIN