Organization
RICHARDSONFAMILYDENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWAYNE RICHARDSON M.D. (OWNER)
(901) 466-9833
Entity
Organization
Contact information
Practice address
17395 HIGHWAY 64, SOMERVILLE, TN 38068-6162
(901) 466-9833
Mailing address
17395 HIGHWAY 64, SOMERVILLE, TN 38068-6162
(901) 466-9833
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS8118
TN
Other
Enumeration date
03/31/2008
Last updated
03/31/2008
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