Provider Demographics
NPI:1215305891
Name:MOLEN, RICHARD (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:MOLEN
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 1:1110 HARVEY RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4218
Mailing Address - Country:US
Mailing Address - Phone:253-939-2552
Mailing Address - Fax:253-939-7672
Practice Address - Street 1:1110 HARVEY RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4218
Practice Address - Country:US
Practice Address - Phone:253-939-2552
Practice Address - Fax:253-939-7672
Is Sole Proprietor?:No
Enumeration Date:2015-09-12
Last Update Date:2015-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00086211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics