Provider Demographics
NPI:1538387063
Name:RICHESON, ROBERT LEE II (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:RICHESON
Suffix:II
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 1:171 SLOAN RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-7391
Mailing Address - Country:US
Mailing Address - Phone:828-369-7133
Mailing Address - Fax:828-369-0683
Practice Address - Street 1:171 SLOAN RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-7391
Practice Address - Country:US
Practice Address - Phone:828-369-7133
Practice Address - Fax:828-369-0683
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5178122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist