DR. Richard Keith Usedom, DDS

NPI #1922263607 in Rockford, Illinois

Provider Information

NPI Number: 1922263607
Entity Type: Individual
Name: DR. Richard Keith Usedom, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 22, 2008
Last Updated: Jul 22, 2008

Practice Location

Address: 6050 BRYNWOOD DR STE 106
City: Rockford
State: Illinois
ZIP Code: 61114-6579
Phone: (815) 877-3565

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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