Provider Demographics
NPI:1306281191
Name:FLORES, RICHARD C (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:FLORES
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 1:16 ARCADE
Mailing Address - Street 2:#198747
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2055
Mailing Address - Country:US
Mailing Address - Phone:615-750-0343
Mailing Address - Fax:615-986-1705
Practice Address - Street 1:2100 MORSE RD
Practice Address - Street 2:SUITE 4655
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-6665
Practice Address - Country:US
Practice Address - Phone:614-470-9840
Practice Address - Fax:614-470-9841
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0239271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice