Individual
DR. LEROY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
100 NW 9TH ST, CHECOTAH, OK 74426
(918) 473-3700
(918) 473-3317
Mailing address
100 NW 9TH ST, PO BOX 328, CHECOTAH, OK 74426
(918) 473-3700
(918) 473-3317
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11482
MO
122300000X
Dentist
Primary
5986
OK
Other
Enumeration date
01/02/2007
Last updated
01/16/2008
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