Organization
RICHARD DIAZ, DDS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD DIAZ DDS (PRESIDENT)
(304) 725-4492
Entity
Organization
Contact information
Practice address
115 S CHARLES ST, CHARLES TOWN, WV 25414-1613
(304) 725-4492
(304) 725-9700
Mailing address
115 S CHARLES ST, CHARLES TOWN, WV 25414-1613
(304) 725-4492
(304) 725-9700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2571
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136653000
—
WV
Enumeration date
07/22/2006
Last updated
08/22/2020
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