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NPI Code Detail

MEDICARE: DR. RICHARD BLETZACKER D.M.D.

MEDICARE:  DR. RICHARD  BLETZACKER  D.M.D.
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
1122300000XDentist10070TN

General Provider Information

NPI Number : 1033592043
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD BLETZACKER D.M.D.
Provider Business Mailing Address
First Line : 2531 PARK DR
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-2158
Country : US
Telephone Number : 615-883-7700
Fax Number :
Provider Business Practice Location Address
First Line : 2531 PARK DR
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-2158
Country : US
Telephone Number : 615-883-7700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2015
Last Update Date : 07/08/2015

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Directions to “ DR. RICHARD BLETZACKER D.M.D.” Practice Location

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