Individual
BONNIE BRYCE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 S MAIN, PIMA, AZ 85543
(928) 965-3851
Mailing address
PO BOX 759, PIMA, AZ 85543-0759
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6219
AZ
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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