Individual
ANDREW KEITH RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1411 FALLS AVE E STE 1000C, TWIN FALLS, ID 83301
(208) 734-7415
Mailing address
3128 HIGHLAWN DR, TWIN FALLS, ID 83301-8415
(928) 322-3137
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D-5045
ID
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/31/2016
Last updated
09/04/2019
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