Provider Demographics
NPI:1871689166
Name:WESTERMAN, RICHARD AUGUST (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:AUGUST
Last Name:WESTERMAN
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 1:16864 RD 30
Mailing Address - Street 2:
Mailing Address - City:DOLORES
Mailing Address - State:CO
Mailing Address - Zip Code:81323-9366
Mailing Address - Country:US
Mailing Address - Phone:970-882-4328
Mailing Address - Fax:
Practice Address - Street 1:18 S BEECH
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-3751
Practice Address - Country:US
Practice Address - Phone:970-565-4702
Practice Address - Fax:970-565-1979
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO807122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02008076Medicaid