MEDICARE: ZONA DENTAL GROUP II, PLLC

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

General Provider Information

NPI Number	:	1427663491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZONA DENTAL GROUP II, PLLC

Provider Business Mailing Address
First Line	:	282 E RIVER RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-5838
Country	:	US
Telephone Number	:	520-293-2997
Fax Number	:	520-293-3910

Provider Business Practice Location Address
First Line	:	282 E RIVER RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-5838
Country	:	US
Telephone Number	:	520-293-2997
Fax Number	:	520-293-3910

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSEPH A RICHARDSON
Credential	:	DDS
Telephone Number	:	520-293-2997

Provider Enumeration Date	:	09/15/2020
Last Update Date	:	09/15/2020

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