Healthcare Provider Details

I. General information

NPI: 1710081195
Provider Name (Legal Business Name): RICHARD L BYRD DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6740 FOREST HILL AVE SUITE 202
RICHMOND VA
23225-1844
US

IV. Provider business mailing address

6740 FOREST HILL AVENUE SUITE 202
RICHMOND VA
23225
US

V. Phone/Fax

Practice location:
  • Phone: 804-320-4155
  • Fax: 804-320-4545
Mailing address:
  • Phone: 804-320-4155
  • Fax: 804-320-4545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0401007026-VA
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: