Individual
DR. CODY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
612 S DETROIT ST, LAGRANGE, IN 46761-2314
(260) 463-2111
Mailing address
7075 N 850 E, HOWE, IN 46746-9598
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12014117A
IN
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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