Provider Demographics
NPI:1336341999
Name:DIMSDALE, RICHARD K (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:K
Last Name:DIMSDALE
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 1:105 WEATHERWATCH LN
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-5568
Mailing Address - Country:US
Mailing Address - Phone:828-456-4282
Mailing Address - Fax:
Practice Address - Street 1:105 WEATHERWATCH LN
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-5568
Practice Address - Country:US
Practice Address - Phone:828-456-4282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC53871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice