Individual
JIMMY J RICHARDSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
840 SE 4TH ST, SUITE 3A, MOORE, OK 73160-7262
(405) 799-7071
(405) 794-5597
Mailing address
840 SE 4TH ST, SUITE 3A, MOORE, OK 73160-7262
(405) 799-7071
(405) 794-5597
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5126
OK
Other
Enumeration date
08/11/2005
Last updated
07/08/2007
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