| Richard Diaz, Dds Inc. | |
|
115 S Charles St Charles Town WV 25414-1613 | |
| (304) 725-4492 | |
| (304) 725-9700 |
| Full Name | Richard Diaz, Dds Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 115 S Charles St, Charles Town, West Virginia |
| Authorized Official Name and Position | Richard Diaz (PRESIDENT) |
| Authorized Official Contact | 3047254492 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Diaz, Dds Inc. 115 S Charles St Charles Town WV 25414-1613 Ph: (304) 725-4492 | Richard Diaz, Dds Inc. 115 S Charles St Charles Town WV 25414-1613 Ph: (304) 725-4492 |
| NPI Number | 1700807856 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700807856 | NPI | - | NPPES |
| 0136653000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2571 (West Virginia) | Primary |
Andrew Lusk Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 46 Trifecta Pl Ste 100, Charles Town, WV 25414 Phone: 304-687-8406 | |
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