Healthcare Provider Details

I. General information

NPI: 1053328740
Provider Name (Legal Business Name): RICHARD STARK FINLAYSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N LOOP 1604 E STE 205
SAN ANTONIO TX
78232-1246
US

IV. Provider business mailing address

10902 ROCKY TRL
SAN ANTONIO TX
78249-4133
US

V. Phone/Fax

Practice location:
  • Phone: 210-496-3869
  • Fax:
Mailing address:
  • Phone: 210-522-0785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number10696
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: