Provider Demographics
NPI:1740334689
Name:RAGNELL, RICHARD DAVIS (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DAVIS
Last Name:RAGNELL
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 1:12820 HILLCREST RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1526
Mailing Address - Country:US
Mailing Address - Phone:972-386-8555
Mailing Address - Fax:
Practice Address - Street 1:12820 HILLCREST RD
Practice Address - Street 2:SUITE 202
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1526
Practice Address - Country:US
Practice Address - Phone:972-386-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice