Provider Demographics
NPI:1285301150
Name:RICHARD DONKERSGOED PLLC
Entity type:Organization
Organization Name:RICHARD DONKERSGOED PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DONKERSGOED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-986-0205
Mailing Address - Street 1:4900 BEE CREEK RD STE 104
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-6776
Mailing Address - Country:US
Mailing Address - Phone:512-266-6366
Mailing Address - Fax:
Practice Address - Street 1:4900 BEE CREEK RD STE 104
Practice Address - Street 2:
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669-6776
Practice Address - Country:US
Practice Address - Phone:512-266-6366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental