MEDICARE: HARRY J RICHTER, DDS, PC

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
1	1223G0001X	General Practice Dentistry	12540	MO

General Provider Information

NPI Number	:	1194934828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRY J RICHTER, DDS, PC

Provider Business Mailing Address
First Line	:	1810 SOUTHWEST BLVD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-2438
Country	:	US
Telephone Number	:	573-634-3413
Fax Number	:	573-634-5818

Provider Business Practice Location Address
First Line	:	1810 SOUTHWEST BLVD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-2438
Country	:	US
Telephone Number	:	573-634-3413
Fax Number	:	573-634-5818

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HARRY JAMES RICHTER
Credential	:	DDS
Telephone Number	:	573-634-3413

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	08/22/2020

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