Gaines, Richard L

Gaines, Richard L is an sole proprietor health care provider with primary practice located at 301 Madison Ave , Lakewood NJ 08701-3266. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Gaines, Richard L can be contacted via phone (732) 367-4042.

Contact Information

Primary practice address
301 Madison Ave Lakewood NJ 08701-3266
Fax: (732) 905-9210
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 22DI00910300 New Jersey

Profile Details

NPI number 1568523538
LBN Legal business name Gaines, Richard L
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 13th, 2006
Last updated Jun 12th, 2009 - about 15 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 1568523538 NPPES
New Jersey MEDICAID 1642006

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