Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 22DI02399300 | NJ |
N | 122300000X | Dentist | 22DI02399301 | NJ |
Y | 1223P0700X | Prosthodontist | DS031282L | PA |
NPI | 1083790877 |
---|---|
Provider Name | Dr. Keith S Richmond |
First Address | Lancaster, PA 17601-2403 |
Second Address | Pittsburgh, PA 15213-2523 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 02/04/2015 |