Individual
BRENDA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
819 S SALINA ST, SYRACUSE, NY 13202-3536
(315) 476-7921
(315) 474-1448
Mailing address
251 SALINA MEADOWS PKWY, SUITE 100, SYRACUSE, NY 13212-4584
(315) 464-2096
(315) 464-2010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
048507
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02218431
—
NY
Enumeration date
04/27/2006
Last updated
05/14/2014
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