Individual
MARY LOU RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
216 MAYFAIR DR, ROCKY MT, NC 27804-3072
(252) 443-4308
Mailing address
216 MAYFAIR DR, ROCKY MT, NC 27804-3072
(252) 443-4308
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6376
NC
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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