Individual
BRYSON RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3671 S SARE RD, BLOOMINGTON, IN 47401-4173
(812) 332-0052
Mailing address
7304 MOSAIC DR, INDIANAPOLIS, IN 46221-9410
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013607A
IN
Other
Enumeration date
05/21/2021
Last updated
05/21/2021
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