Provider Demographics
NPI:1962610485
Name:ISAACSON, RICHARD DEAN (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DEAN
Last Name:ISAACSON
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 1:532 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1758
Mailing Address - Country:US
Mailing Address - Phone:732-222-1294
Mailing Address - Fax:
Practice Address - Street 1:103 PARKER ROAD
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764
Practice Address - Country:US
Practice Address - Phone:732-870-8077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics