Individual
JEREMY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
58 WARM SPRINGS AVE, MARTINSBURG, WV 25404-3800
(304) 267-0250
Mailing address
PO BOX 1146, MARTINSBURG, WV 25402-1146
(304) 263-4999
(304) 263-0984
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4289
WV
Other
Enumeration date
07/25/2017
Last updated
07/25/2017
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