Provider Demographics
NPI:1316053317
Name:PUGLIESE, RICHARD A (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:PUGLIESE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:502 STRAWBERRY PLAINS RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-3442
Mailing Address - Country:US
Mailing Address - Phone:757-259-9703
Mailing Address - Fax:757-259-9715
Practice Address - Street 1:502 STRAWBERRY PLAINS RD
Practice Address - Street 2:SUITE D
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-3442
Practice Address - Country:US
Practice Address - Phone:757-259-9703
Practice Address - Fax:757-259-9715
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA04010046931223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry