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NPI Code Detail

MEDICARE: ANNA MOORE RICHARDSON D.D.S.

MEDICARE: ANNA MOORE RICHARDSON D.D.S.
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
1122300000XDentist0401415150VA

General Provider Information

NPI Number : 1306230016
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA MOORE RICHARDSON D.D.S.
Provider Business Mailing Address
First Line : 4909 GROVE AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23226-1649
Country : US
Telephone Number : 804-355-3100
Fax Number :
Provider Business Practice Location Address
First Line : 4909 GROVE AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23226-1649
Country : US
Telephone Number : 804-355-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2015
Last Update Date : 08/06/2019

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