Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | 04003 | NH |
Y | 1223P0221X | Pediatric Dentist | DN1856102 | MA |
NPI | 1013200641 |
---|---|
Provider Name | Dr. Michael Daniel Richler |
First Address | Leominster, MA 01453-5649 |
Second Address | Leominster, MA 01453-5649 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2011 |
Last Update Date | 11/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DN1856102 | (05) | MA |