| Richardsonfamilydentistry | |
|
17395 Highway 64 Somerville TN 38068-6162 | |
| (901) 466-9833 | |
| Not Available |
| Full Name | Richardsonfamilydentistry |
|---|---|
| Speciality | Dentist |
| Location | 17395 Highway 64, Somerville, Tennessee |
| Authorized Official Name and Position | Dwayne Richardson (OWNER) |
| Authorized Official Contact | 9014669833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richardsonfamilydentistry 17395 Highway 64 Somerville TN 38068-6162 Ph: (901) 466-9833 | Richardsonfamilydentistry 17395 Highway 64 Somerville TN 38068-6162 Ph: (901) 466-9833 |
| NPI Number | 1053583005 |
|---|---|
| Provider Enumeration Date | 03/31/2008 |
| Last Update Date | 03/31/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053583005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS8118 (Tennessee) | Primary |
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