Leroy Richardson, DDS Valid NPI
Individual provider · Dentist · Checotah, OK
- NPI
- 1659438653
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- 5986 (OK)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2007-01-02
- Last updated
- 2008-01-16
Practice location
100 Nw 9th St
Checotah, OK 74426
(918) 473-3700