Individual
DR. RICHARD TODD CRIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1340 S MAIN ST, MADISONVILLE, KY 42431-3342
(270) 825-0676
(270) 825-0696
Mailing address
1340 S MAIN ST, MADISONVILLE, KY 42431-3342
(270) 825-0676
(270) 825-0696
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8199
KY
1223G0001X
General Practice Dentistry
Primary
8199
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122300000X
—
KY
05
—
60003829
—
KY
Enumeration date
07/06/2006
Last updated
05/16/2011
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