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General NPI Number Information
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NPI Number | 1366498826
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Entity Type | Organization
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Legal Business Name | RICHARD L. TRIPPIE, D.D.S. AND RALPH A. TRAYLOR, D.D.S., L.L.P.
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4001 GARTH RD SUITE 104
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City | BAYTOWN
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State | TX
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Zip | 77521-3115
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Country | US
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Telephone | 281-427-4736
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Fax | 281-427-7127
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Provider Business Mailing Address
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Address Line | 4001 GARTH RD SUITE 104
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City | BAYTOWN
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State | TX
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Zip | 77521-3115
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Country | US
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Telephone | 281-427-4736
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Fax | 281-427-7127
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Authorized Official
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Title or Position | PARTNER
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Name | DR. RICHARD LEE TRIPPIE
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Credential | D.D.S.
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Telephone | 281-427-4736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 10177
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License Number State | TX
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