Provider Demographics
NPI:1881399814
Name:SEGGERMAN, RICHARD BURKE (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BURKE
Last Name:SEGGERMAN
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 1:5132 VILLAGE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4497
Mailing Address - Country:US
Mailing Address - Phone:972-381-1888
Mailing Address - Fax:
Practice Address - Street 1:5132 VILLAGE CREEK DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4497
Practice Address - Country:US
Practice Address - Phone:972-381-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX398681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice