Individual
RICHARD R. BANKHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1259 HYDE PARK AVE, HYDE PARK, MA 02136-2817
(617) 364-5500
(617) 361-1351
Mailing address
136 JACKSON ST, NEWTON, MA 02459-2538
(617) 332-1335
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14255
MA
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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