Provider Demographics
NPI:1972949683
Name:DUVALL, RICHARD ARTHUR (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ARTHUR
Last Name:DUVALL
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 1:712 FORT CROOK RD N
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-4558
Mailing Address - Country:US
Mailing Address - Phone:402-733-6066
Mailing Address - Fax:
Practice Address - Street 1:712 FORT CROOK RD N
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-4558
Practice Address - Country:US
Practice Address - Phone:402-733-6066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7088122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist