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NPI Code Detail

MEDICARE: MICHAEL F RICHARDS DDS

MEDICARE: MICHAEL F RICHARDS DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry1456079921UT

General Provider Information

NPI Number : 1689743254
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL F RICHARDS DDS
Provider Business Mailing Address
First Line : 2091 E 1300 SO
Second Line : #205
City : SALT LAKE CITY
State : UT
Zip : 84108
Country : US
Telephone Number : 801-581-9300
Fax Number : 801-583-8412
Provider Business Practice Location Address
First Line : 2091 E 1300 SO
Second Line : #205
City : SALT LAKE CITY
State : UT
Zip : 84108
Country : US
Telephone Number : 801-581-9300
Fax Number : 801-583-8412
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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