Doctor Name: | DR. LISA ANNE RICHARDS |
NPI Number: | 1013139492 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DDS |
License Number: | 18715 |
Business Practice Address: | 4699 Hamann Pkwy Willoughby, OH - 440945631 |
Business Phone Number: | 4409420860 |
Business Fax Number: | 4409511246 |
Mailing Address: | 4699 Hamann Pkwy, WILLOUGHBY |
State: | OH |
Postal Code: | 440945631 |
Phone Number: | 4409420860 |
Fax Number: | 4409511246 |
NPI Enumeration Date: | 05/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 18715 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |