Individual
MELODY MILLER RICHARDSON
Inactive
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
63 WEST 6TH ST, PERU, IN 46970-2134
(765) 473-4109
Mailing address
63 WEST SIXTH ST, PERU, IN 46970-2134
(765) 473-4109
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009144A
IN
Other
Enumeration date
11/02/2006
Last updated
10/22/2021
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