Individual
DR. ESAIAS STEVEN RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1800 F S HILL DR, STE A, GRENADA, MS 38901-5048
(662) 226-1757
(662) 307-2709
Mailing address
1800 F S HILL DR, STE A, GRENADA, MS 38901-5048
(662) 226-1757
(662) 307-2709
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3275-03
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01078012
—
MS
01
—
20-1728874
EMPLOYER IDENTIFIER NUMBE
MS
Enumeration date
07/27/2006
Last updated
09/09/2015
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