Provider Demographics
NPI:1215095229
Name:SCHIRMER, RICHARD R (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:R
Last Name:SCHIRMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 LONG ST
Mailing Address - Street 2:
Mailing Address - City:SWEET HOME
Mailing Address - State:OR
Mailing Address - Zip Code:97386-2326
Mailing Address - Country:US
Mailing Address - Phone:541-367-2164
Mailing Address - Fax:541-367-5714
Practice Address - Street 1:1818 LONG ST
Practice Address - Street 2:
Practice Address - City:SWEET HOME
Practice Address - State:OR
Practice Address - Zip Code:97386-2326
Practice Address - Country:US
Practice Address - Phone:541-367-2164
Practice Address - Fax:541-367-5714
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD50991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice