Healthcare Provider Details

I. General information

NPI: 1831192822
Provider Name (Legal Business Name): RICHARD ARMSTRONG D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 E 18TH ST STE A
COSTA MESA CA
92627-3000
US

IV. Provider business mailing address

181 E 18TH ST STE A
COSTA MESA CA
92627-3000
US

V. Phone/Fax

Practice location:
  • Phone: 949-548-1262
  • Fax:
Mailing address:
  • Phone: 949-548-1262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number29550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: