Boone, Richard Todd
Boone, Richard Todd is an sole proprietor health care provider with primary practice located at 803 N Monte Vista St , Ada OK 74820-7711. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Boone, Richard Todd can be contacted via phone (580) 332-3010.Contact Information
Primary practice address
803 N Monte Vista St
Ada OK 74820-7711
Phone: (580) 332-3010
Fax: (580) 332-1302
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 4808 | Oklahoma |
Profile Details
| NPI number | 1730172263 |
|---|---|
| LBN Legal business name | Boone, Richard Todd |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 30th, 2005 |
| Last updated | Aug 7th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730172263 | NPPES |
| Oklahoma | MEDICAID | 100112550A | |
| Oklahoma | Other | 787600 |
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