Organization
AURORA PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM RICHARDSON DDS,MS (PEDIATRIC DENTIST/OWNER)
(918) 640-1092
Entity
Organization
Contact information
Practice address
3008 W HEFNER RD, OKLAHOMA CITY, OK 73120-5107
(918) 640-1092
Mailing address
2800 STILL MEADOW RD, EDMOND, OK 73013-6726
(918) 640-1092
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346734431
—
OK
05
—
1679073167
—
OK
Enumeration date
12/07/2022
Last updated
12/07/2022
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