Organization
JOHN V.D. RICHARDSON, DDS., INC
Active
Parent organization
JOHN V.D. RICHARDSON DDS., INC
Other names
John D Richardson DDS
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHN V.D. RICHARDSON DDS., INC
Authorized official
DR. JOHN VERNON DALE RICHARDSON DDS. (PRESIDENT)
(559) 992-4138
Entity
Organization
Contact information
Practice address
1409 WHITLEY AVE, SUITE D, CORCORAN, CA 93212-2223
(559) 992-4138
(559) 992-4079
Mailing address
1409 WHITLEY AVE, SUITE D, CORCORAN, CA 93212-2223
(559) 992-4138
(559) 992-4079
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
39700
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223000000X
TAXONOMY CODE
—
01
—
1255480406
INDIVIDUAL NPI
—
Enumeration date
01/23/2015
Last updated
01/23/2015
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