Provider Demographics
NPI:1407180359
Name:RICHARDSON, MOLLIE ERIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOLLIE
Middle Name:ERIN
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4780 S MEADE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1614
Mailing Address - Country:US
Mailing Address - Phone:720-524-3854
Mailing Address - Fax:
Practice Address - Street 1:2630 W BELLEVIEW AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-7188
Practice Address - Country:US
Practice Address - Phone:720-524-3854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO94771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice