Provider Demographics
NPI:1902184799
Name:RASMUSSEN, RICHARD ALLYN III (DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALLYN
Last Name:RASMUSSEN
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 CYPRESS CV
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6783
Mailing Address - Country:US
Mailing Address - Phone:813-502-1302
Mailing Address - Fax:
Practice Address - Street 1:2306 CYPRESS CV
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6783
Practice Address - Country:US
Practice Address - Phone:813-502-1302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN193951223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics