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General NPI Number Information
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NPI Number | 1639217284
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Entity Type | Individual
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Provider Name | RICHARD JOHN AHLFELD D.D.S
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Gender | Male
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 400 HARTNELL AVE
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City | REDDING
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State | CA
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Zip | 96002-1848
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Country | US
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Telephone | 530-222-2473
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Fax |
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Provider Business Mailing Address
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Address Line | 15368 PROSPECT DR
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City | REDDING
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State | CA
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Zip | 96001-9558
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Country | US
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Telephone | 415-531-6586
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 22939
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License Number State | CA
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