Individual
FAIN RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 622, PINETOP, AZ 85935-0622
(970) 620-0060
Mailing address
3470 COUNTY ROAD 13, MEEKER, CO 81641-7719
(970) 620-0060
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001010-14
WI
Other
Enumeration date
09/08/2014
Last updated
10/24/2024
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