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General NPI Number Information
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NPI Number | 1306245840
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Entity Type | Organization
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Legal Business Name | HEATHER R RICHARDSON DMD MS
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 7384 S ALTON WAY STE 101
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City | CENTENNIAL
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State | CO
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Zip | 80112-2369
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Country | US
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Telephone | 30-721-1173
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Fax | 303-721-1179
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Provider Business Mailing Address
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Address Line | 7384 S ALTON WAY STE 101
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City | CENTENNIAL
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State | CO
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Zip | 80112-2369
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Country | US
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Telephone | 30-721-1173
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Fax | 303-721-1179
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. HEATHER R RICHARDSON
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Credential | DMD MS
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Telephone | 303-721-1173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 9476
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License Number State | CO
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