DR. Kenneth E Richardson, D.D.S.

NPI #1053407585 in Boise, Idaho

Provider Information

NPI Number: 1053407585
Entity Type: Individual
Name: DR. Kenneth E Richardson, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: Oct 4, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 2720 OVERLAND ROAD
City: Boise
State: Idaho
ZIP Code: 83705
Phone: (208) 345-5875

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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