Provider Demographics
NPI:1881798809
Name:TATE, RICHARD CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CHARLES
Last Name:TATE
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 1:11327 ARCADE DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-4015
Mailing Address - Country:US
Mailing Address - Phone:501-225-3977
Mailing Address - Fax:501-225-3988
Practice Address - Street 1:11327 ARCADE DR
Practice Address - Street 2:SUITE D
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-4015
Practice Address - Country:US
Practice Address - Phone:501-225-3977
Practice Address - Fax:501-225-3988
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR25241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice