Jake Richardson, D.M.D.

NPI #1568024347 in Fort Duchesne, Utah

Provider Information

NPI Number: 1568024347
Entity Type: Individual
Name: Jake Richardson, D.M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.M.D.
Enumeration Date: Jul 2, 2019
Last Updated: Jul 2, 2019

Practice Location

Address: 6932 E 1400 S
City: Fort Duchesne
State: Utah
ZIP Code: 84026
Phone: (435) 722-5122

Specialties & Taxonomy Codes

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

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