Provider Demographics
NPI:1336156801
Name:GORE, RICHARD LLOYD (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LLOYD
Last Name:GORE
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 1:11 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3843
Mailing Address - Country:US
Mailing Address - Phone:501-225-2929
Mailing Address - Fax:501-228-6646
Practice Address - Street 1:11 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3843
Practice Address - Country:US
Practice Address - Phone:501-225-2929
Practice Address - Fax:501-228-6646
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR24641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice