Organization
DWAYNE F RICHARDSON DDS ESTATE
Active
Other names
Richardson Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ATHENA MICHELLE RICHARDSON (OWNER)
(662) 292-0722
Entity
Organization
Contact information
Practice address
17395 US HIGHWAY 64, SOMERVILLE, TN 38068-6162
(901) 466-9833
(901) 466-9834
Mailing address
17395 US HIGHWAY 64, SOMERVILLE, TN 38068-6162
(901) 466-9833
(901) 466-9834
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/28/2013
Last updated
03/28/2013
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