Individual
DR. JOHN JOSEPH RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
690 NORTH ROUTE 31, CRYSTAL LAKE, IL 60012
(815) 459-5600
(815) 459-5601
Mailing address
9915 CARLISLE LN, VILLAGE OF LAKEWOOD, IL 60014-4819
(815) 444-1533
(815) 459-5601
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
IL
Other
Enumeration date
01/11/2006
Last updated
07/08/2007
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