Shea, Richard John
Shea, Richard John is an individual health care provider with primary practice located at 335 Corey St , West Roxbury MA 02132. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Shea, Richard John can be contacted via phone (617) 327-5335.Contact Information
Primary practice address
335 Corey St
West Roxbury MA 02132
Phone: (617) 327-5335
Fax: (617) 696-4051
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 9729 | Massachusetts |
Profile Details
| NPI number | 1982797908 |
|---|---|
| LBN Legal business name | Shea, Richard John |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1982797908 | NPPES |
| Other | X02883SH | BLUE CROSS-SHIELD | |
| MEDICAID | 0291455 | BLUE CROSS-SHIELD | |
| Other | 90694 | BLUE CROSS-SHIELD |
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