Healthcare Provider Details

I. General information

NPI: 1114075710
Provider Name (Legal Business Name): RICHARD S APPLETON D.D.S.,M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4970 BLUEBONNET BLVD SUITE A
BATON ROUGE LA
70809-3089
US

IV. Provider business mailing address

4970 BLUEBONNET BLVD SUITE A
BATON ROUGE LA
70809-3089
US

V. Phone/Fax

Practice location:
  • Phone: 225-291-6221
  • Fax: 225-291-6222
Mailing address:
  • Phone: 225-291-6221
  • Fax: 225-291-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number4768
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: