Provider Demographics
NPI:1477937167
Name:RICHARDS, TAFT III (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAFT
Middle Name:
Last Name:RICHARDS
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 TEAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-3619
Mailing Address - Country:US
Mailing Address - Phone:469-323-3741
Mailing Address - Fax:
Practice Address - Street 1:1110 TEAKWOOD DR
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-3619
Practice Address - Country:US
Practice Address - Phone:469-323-3741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX311491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice