Organization
GREGORY L. RICHARDSON DDS.MS.PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY L RICHARDSON DDS (OWNER)
(910) 452-7988
Entity
Organization
Contact information
Practice address
2606 IRON GATE DR, SUITE 101, WILMINGTON, NC 28412-2573
(910) 452-7988
(910) 452-7632
Mailing address
2606 IRON GATE DR, SUITE 101, WILMINGTON, NC 28412-2573
(910) 452-7988
(910) 452-7932
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
5744
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899736B
—
NC
Enumeration date
03/13/2008
Last updated
03/13/2008
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