Individual
DR. JONATHAN FIFE RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
5991 S 3500 W, SUITE 200, ROY, UT 84067-6701
(801) 779-2700
Mailing address
4918 W HAVEN RD, WEST HAVEN, UT 84401-6839
(952) 201-3643
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
5348402-9922
UT
1223G0001X
General Practice Dentistry
5348402-9922
UT
Other
Enumeration date
09/07/2005
Last updated
08/25/2008
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