Healthcare Provider Details

I. General information

NPI: 1336185891
Provider Name (Legal Business Name): ANNE BRITT RICHARDSON DOM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 CAMINO DE MONTE REY STE A8
SANTA FE NM
87505-3977
US

IV. Provider business mailing address

PO BOX 628
TESUQUE NM
87574-0628
US

V. Phone/Fax

Practice location:
  • Phone: 505-660-9413
  • Fax:
Mailing address:
  • Phone: 505-660-9413
  • Fax: 505-747-7968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number798
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: