# KENITRA C. RICHARDSON, DMD, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Peace Haven Smiles
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013675842
- **Authorized official:** KENITRA RICHARDSON DMD (DENTIST/OWNER/MANAGER)
- **Authorized official phone:** (336) 314-8535

## Contact information

- **Practice address:** 10215 PROSPERITY PARK DR STE 220, CHARLOTTE, NC 28269-1103
- **Practice address phone:** (980) 423-1144
- **Mailing address:** 10215 PROSPERITY PARK DR STE 220, CHARLOTTE, NC 28269-1103
- **Mailing address phone:** (980) 423-1144
- **Mailing address fax:** (980) 423-1188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/29/2021
- **Last updated:** 11/29/2021