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Individual
CHASE RICHARDS
Active
Individual
CHASE RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
9712
SC
1223P0300X
Periodontics
Primary
132148909924
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/09/2020
Last updated
12/01/2023
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