Smith, Richard Dewayne
Smith, Richard Dewayne is an individual health care provider with primary practice located at 2690 Ne Kresky Ave , Chehalis WA 98532-2412. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Smith, Richard Dewayne can be contacted via phone (360) 330-9595.Contact Information
Primary practice address
2690 Ne Kresky Ave
Chehalis WA 98532-2412
Phone: (360) 330-9595
Fax: (360) 330-9580
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 9596 | Washington |
Profile Details
| NPI number | 1881724987 |
|---|---|
| LBN Legal business name | Smith, Richard Dewayne |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 7th, 2007 |
| Last updated | Dec 21st, 2021 - about 4 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 | 1881724987 | NPPES |
| Washington | MEDICAID | 2200506 |
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