Individual
DR. DAVID THOMAS RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1200 MAIN ST, LA CROSSE, WI 54601-4102
(608) 782-5675
(608) 784-7379
Mailing address
N1125 MORMON DR, LA CROSSE, WI 54601-2148
(608) 788-7164
(608) 784-7379
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1245-G
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33579000
—
WI
Enumeration date
07/25/2006
Last updated
07/09/2007
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