Provider Demographics
NPI:1356598882
Name:RICHARDSON, MARTINA SASKIA (DDS)
Entity type:Individual
Prefix:DR
First Name:MARTINA
Middle Name:SASKIA
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 1:330 E 14 MILE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-2100
Mailing Address - Country:US
Mailing Address - Phone:248-589-2021
Mailing Address - Fax:
Practice Address - Street 1:330 E 14 MILE RD
Practice Address - Street 2:SUITE A
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-2100
Practice Address - Country:US
Practice Address - Phone:248-589-2021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010197951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice