| John D Richardson Dds | |
|
1409 Whitley Ave Suite D Corcoran CA 93212-2223 | |
| (559) 992-4138 | |
| (559) 992-4079 |
| Full Name | John D Richardson Dds |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1409 Whitley Ave, Corcoran, California |
| Authorized Official Name and Position | John Vernon Dale Richardson (PRESIDENT) |
| Authorized Official Contact | 5599924138 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John D Richardson Dds 1409 Whitley Ave Suite D Corcoran CA 93212-2223 Ph: (559) 992-4138 | John D Richardson Dds 1409 Whitley Ave Suite D Corcoran CA 93212-2223 Ph: (559) 992-4138 |
| NPI Number | 1033509435 |
|---|---|
| Provider Enumeration Date | 01/23/2015 |
| Last Update Date | 01/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033509435 | NPI | - | NPPES |
| 1255480406 | Other | INDIVIDUAL NPI | |
| 1223000000X | Other | TAXONOMY CODE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 39700 (California) | Primary |
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