Individual
MR. EUGENE ARTHUR RICHARDSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
23 SHORE STREET, PETERSBURG, VA 23803
(804) 861-5331
(804) 861-5351
Mailing address
23 SHORE STREET, PETERSBURG, VA 23803
(804) 861-5331
(804) 861-5351
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401005258
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003363
BCBS ANTHEM DENTAL
VA
01
—
4066921
BCBS TENNESSEE
VA
05
—
9178831
—
VA
Enumeration date
09/20/2006
Last updated
07/08/2007
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