Organization
DR. EUGENE A. RICHARDSON III
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE ARTHUR RICHARDSON III (DENTIST)
(804) 861-5330
Entity
Organization
Contact information
Practice address
23 SHORE ST, PETERSBURG, VA 23803-5818
(804) 861-5331
(804) 861-5351
Mailing address
23 SHORE ST, PETERSBURG, VA 23803-5818
(804) 861-5331
(804) 861-5351
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401005258
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003363
ANTHEM
VA
01
—
4066921
BC/BS
TN
01
—
691160
UNITED CONCORDIA
PA
05
—
9178831
—
VA
Enumeration date
03/03/2008
Last updated
03/03/2008
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