Provider Demographics
NPI:1962608471
Name:ANDREA RICHMAN DMD PC
Entity type:Organization
Organization Name:ANDREA RICHMAN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-369-7967
Mailing Address - Street 1:PO BOX 576
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:MA
Mailing Address - Zip Code:01741-0576
Mailing Address - Country:US
Mailing Address - Phone:978-369-7967
Mailing Address - Fax:
Practice Address - Street 1:18 WESTFORD ROAD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:MA
Practice Address - Zip Code:01741-0174
Practice Address - Country:US
Practice Address - Phone:978-369-7967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental