Individual
DR. BENJAMIN QUENZER RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
95 S WAUKEGAN RD, DEERFIELD, IL 60015-5204
(224) 515-7390
Mailing address
1909 W NORTH AVE APT 2, CHICAGO, IL 60622-1335
(812) 550-4391
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.035650
IL
Other
Enumeration date
05/25/2021
Last updated
01/04/2025
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