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General NPI Number Information
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NPI Number | 1538493317
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Entity Type | Organization
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Legal Business Name | RICHARD A. LOOK, D.D.S., INC.
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Dates
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Enumeration Date | 09/25/2009
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Last Update Date | 09/25/2009
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Provider Practice Location Address
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Address Line | 2710 EUREKA WAY STE 3
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City | REDDING
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State | CA
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Zip | 96001-0230
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Country | US
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Telephone | 530-241-6374
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Fax | 530-241-5140
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Provider Business Mailing Address
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Address Line | 2710 EUREKA WAY STE 3
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City | REDDING
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State | CA
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Zip | 96001-0230
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Country | US
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Telephone | 530-241-6374
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Fax | 530-241-5140
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Authorized Official
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Title or Position | ACCOUNTS RECEIVABLE
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Name | MRS. EMILY ANN JOHNSON
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Credential |
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Telephone | 530-241-6374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 22817
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License Number State | CA
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