Provider Demographics
NPI:1336360312
Name:NOCK, RICHARD DALE (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DALE
Last Name:NOCK
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 1:9894 ROSEMONT AVENUE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-4102
Mailing Address - Country:US
Mailing Address - Phone:303-758-2244
Mailing Address - Fax:
Practice Address - Street 1:9894 ROSEMONT AVENUE
Practice Address - Street 2:SUITE 204
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-4102
Practice Address - Country:US
Practice Address - Phone:303-758-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6894122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist