Organization
RICHARD D. DIETZ, DDS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD DAVID DIETZ, D.D.S. (PRESIDENT)
(937) 653-5359
Entity
Organization
Contact information
Practice address
314 PATRICK AVENUE, URBANA, OH 43078
(937) 653-5359
(937) 653-5964
Mailing address
314 PATRICK AVENUE, URBANA, OH 43078
(937) 653-5359
(937) 653-5964
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-015069
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0321226
—
OH
Enumeration date
10/02/2006
Last updated
07/07/2008
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