Individual
DR. RICHARD ALAN SAMPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
111 W 20TH AVE, BELLEVUE, NE 68005-5014
(402) 291-4995
(402) 291-4995
Mailing address
111 W 20TH AVE, BELLEVUE, NE 68005-5014
(402) 291-4995
(402) 291-4995
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4265
NE
Other
Enumeration date
10/23/2008
Last updated
10/23/2008
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