MEDICARE: DR. WAYNE LEE RICHEY D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	19460	CA

General Provider Information

NPI Number	:	1023286499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE LEE RICHEY D.D.S.

Provider Business Mailing Address
First Line	:	880 CASS ST
Second Line	:	#104
City	:	MONTEREY
State	:	CA
Zip	:	93940-2947
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 CASS ST
Second Line	:	#104
City	:	MONTEREY
State	:	CA
Zip	:	93940-2947
Country	:	US
Telephone Number	:	831-373-3531
Fax Number	:	831-373-3571

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	02/19/2008

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Directions to “ DR. WAYNE LEE RICHEY D.D.S.” Practice Location

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