Individual
DR. TREVOR DANIEL RICHMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
11825 N KNOXVILLE AVE, DUNLAP, IL 61525-8842
(309) 740-3901
Mailing address
7713 S STRANZ RD, MAPLETON, IL 61547-9412
(309) 431-1512
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.032728
IL
1223P0300X
Periodontics
Primary
021.003328
IL
Other
Enumeration date
06/24/2020
Last updated
08/09/2024
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