Misty Denise Richardson

NPI #1245583632 in Salem, Oregon

Provider Information

NPI Number: 1245583632
Entity Type: Individual
Name: Misty Denise Richardson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Assistant
Enumeration Date: Oct 23, 2012
Last Updated: Oct 23, 2012

Practice Location

Address: 2300 LANCASTER DR NE
City: Salem
State: Oregon
ZIP Code: 97305-1223
Phone: (503) 370-4311

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Assistant	126800000X	Primary

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