Healthcare Provider Details

I. General information

NPI: 1306281191
Provider Name (Legal Business Name): RICHARD C FLORES DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 MORSE RD SUITE 4655
COLUMBUS OH
43229-6665
US

IV. Provider business mailing address

16 ARCADE #198747
NASHVILLE TN
37219-2055
US

V. Phone/Fax

Practice location:
  • Phone: 614-470-9840
  • Fax: 614-470-9841
Mailing address:
  • Phone: 615-750-0343
  • Fax: 615-986-1705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30-023927
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: