Provider Demographics
NPI:1407070733
Name:RICHTER, NEVILLE W (DDS, PS)
Entity type:Individual
Prefix:
First Name:NEVILLE
Middle Name:W
Last Name:RICHTER
Suffix:
Gender:M
Credentials:DDS, PS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10655 NE 4TH ST STE 308
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-5022
Mailing Address - Country:US
Mailing Address - Phone:425-637-1179
Mailing Address - Fax:425-450-1556
Practice Address - Street 1:10655 NE 4TH ST STE 308
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5022
Practice Address - Country:US
Practice Address - Phone:425-637-1179
Practice Address - Fax:425-450-1556
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE50471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice