Individual
RICHARD M OMOHUNDRO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
214 E 2ND ST, FULTON, MO 65251-1650
(573) 642-6624
(573) 642-6210
Mailing address
1311 CEDARWOOD DR, FULTON, MO 65251-2276
(573) 642-5075
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12926
MO
Other
Enumeration date
05/24/2005
Last updated
07/08/2007
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