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General NPI Number Information
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NPI Number | 1578731782
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Entity Type | Individual
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Provider Name | RICHARD JAMES OWEN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 07/24/2013
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Provider Practice Location Address
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Address Line | 301 E LOHMAN AVE
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City | LAS CRUCES
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State | NM
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Zip | 88001-3667
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Country | US
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Telephone | 575-524-4900
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Fax | 575-524-8300
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Provider Business Mailing Address
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Address Line | 4208 HERMIA CT
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City | LAS CRUCES
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State | NM
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Zip | 88011-0918
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Country | US
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Telephone | 305-206-5318
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DD3268
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License Number State | NM
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