Provider Demographics
NPI:1992894729
Name:BLUMENFELD, RICHARD C (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:BLUMENFELD
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 1:279 BROWERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WEST PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2663
Mailing Address - Country:US
Mailing Address - Phone:973-256-3366
Mailing Address - Fax:
Practice Address - Street 1:279 BROWERTOWN RD
Practice Address - Street 2:
Practice Address - City:WEST PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07424-2663
Practice Address - Country:US
Practice Address - Phone:973-256-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D100824300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist