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Individual

DR. RICHARD SHINICHIRO CARLILE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., MS

Contact information

Practice address
93 S MAIN ST, MANTI, UT 84642-1350
(435) 835-4881
Mailing address
93 S MAIN ST, MANTI, UT 84642-1350
(435) 835-4881

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
0401413223
VA
1223G0001X
General Practice Dentistry
0401413223
VA
1223G0001X
General Practice Dentistry
Primary
12720188-9924
UT
1223G0001X
General Practice Dentistry
DE 60745129
WA

Other

Enumeration date
08/12/2011
Last updated
01/07/2023
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