Healthcare Provider Details

I. General information

NPI: 1083636328
Provider Name (Legal Business Name): RICHARD WESLEY FRENCH DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 06/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 COPPER COVE DR STE A
COPPEROPOLIS CA
95228-9373
US

IV. Provider business mailing address

90 COPPER COVE DR STE A
COPPEROPOLIS CA
95228-9373
US

V. Phone/Fax

Practice location:
  • Phone: 209-785-7171
  • Fax: 209-729-5858
Mailing address:
  • Phone: 209-785-7171
  • Fax: 209-729-5858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number29798
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: