Provider Demographics
NPI:1356404412
Name:PAULEY, RICHARD LYMAN (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:LYMAN
Last Name:PAULEY
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 1:14752 WARWICK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-3654
Mailing Address - Country:US
Mailing Address - Phone:757-874-4501
Mailing Address - Fax:757-877-8192
Practice Address - Street 1:14752 WARWICK BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-3654
Practice Address - Country:US
Practice Address - Phone:757-874-4501
Practice Address - Fax:757-877-8192
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4352122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist