Provider Demographics
NPI:1396881330
Name:CAVEN, RICHARD CHACE (DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CHACE
Last Name:CAVEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8930 RG SKINNER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:904-645-3366
Mailing Address - Fax:904-645-3377
Practice Address - Street 1:8930 RG SKINNER PARKWAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256
Practice Address - Country:US
Practice Address - Phone:904-645-3366
Practice Address - Fax:904-645-3377
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDN14272332B00000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies