Diaz, Richard Nelson

Diaz, Richard Nelson is an individual health care provider with primary practice located at 115 S Charles St , Charles Town WV 25414. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Diaz, Richard Nelson can be contacted via phone (304) 725-4492.

Contact Information

Primary practice address
115 S Charles St Charles Town WV 25414
Phone: (304) 725-4492
Fax: (304) 725-9700
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 84 Maryland
Dental Providers / General Practice 1223G0001X 2571 West Virginia

Profile Details

NPI number 1760406706
LBN Legal business name Diaz, Richard Nelson
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Jul 2nd, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760406706 NPPES
West Virginia MEDICAID 0136653000

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