Individual
BRANDON RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2630 CENTRAL AVE, EIELSON AFB, AK 99702-2301
(907) 377-6559
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2273
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8394383-9922
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/27/2023
Last updated
08/20/2024
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