Provider Demographics
NPI:1912516923
Name:RASH, RICHARD HOUSTON (DMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:HOUSTON
Last Name:RASH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N KEENE ST STE 202-210
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8050
Mailing Address - Country:US
Mailing Address - Phone:573-817-2222
Mailing Address - Fax:
Practice Address - Street 1:303 N KEENE ST STE 202-210
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8050
Practice Address - Country:US
Practice Address - Phone:573-817-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-26
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020023287122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist