Individual
MR. PAUL EDWARD RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3452 GRAYSTONE PLACE SE, HICKORY, NC 28601
(828) 322-1667
(828) 485-3208
Mailing address
PO BOX 2526, HICKORY, NC 28603-2526
(828) 322-1667
(828) 485-3208
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7320
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1309318
TRICARE
NC
05
—
8990167
—
NC
01
—
90167
BLUE CROSS BLUE SHIELD
NC
Enumeration date
10/27/2005
Last updated
07/08/2007
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