Provider Demographics
NPI:1144431206
Name:NAGEL, RICHARD STEPHEN (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:STEPHEN
Last Name:NAGEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 BROADWAY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-2054
Mailing Address - Country:US
Mailing Address - Phone:201-666-0770
Mailing Address - Fax:201-666-3620
Practice Address - Street 1:185 BROADWAY
Practice Address - Street 2:SUITE 3
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642-2054
Practice Address - Country:US
Practice Address - Phone:201-666-0770
Practice Address - Fax:201-666-3620
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI017510001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice