Organization
BEVAN RICHARDSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE DAVIDSON (OFFICE ADMINISTRATOR)
(916) 991-6402
Entity
Organization
Contact information
Practice address
851 OAK LN, RIO LINDA, CA 95673-2341
(916) 991-6402
(916) 991-7297
Mailing address
851 OAK LN, RIO LINDA, CA 95673-2341
(916) 991-6402
(916) 991-7297
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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