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General NPI Number Information
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NPI Number | 1053670141
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Entity Type | Organization
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Legal Business Name | PETER A. RICH, D.M.D. INC.
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 15835 POMERADO ROAD 101
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City | POWAY
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State | CA
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Zip | 92064-2042
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Country | US
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Telephone | 858-487-4727
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Fax |
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Provider Business Mailing Address
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Address Line | 15835 POMERADO ROAD 101
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City | POWAY
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State | CA
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Zip | 92064-2042
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. PETER A RICH
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Credential | D.M.D.
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Telephone | 619-540-0816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 57833
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License Number State | CA
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