Individual
DR. GREGORY L RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
2606 IRON GATE DRIVE, SUITE 101, WILMINGTON, NC 28412
(910) 452-7988
(910) 452-7932
Mailing address
407 WEST RENOVAH CIRCLE, WILMINGTON, NC 28403
(910) 343-1260
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5744
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899736B
—
NC
Enumeration date
04/23/2007
Last updated
07/08/2007
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