Provider Demographics
NPI:1396348223
Name:TORIE L RICHARDSON DDS LLC
Entity type:Organization
Organization Name:TORIE L RICHARDSON DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TORIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-206-1618
Mailing Address - Street 1:16000 PROSPERITY DR STE 400
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-4322
Mailing Address - Country:US
Mailing Address - Phone:317-770-1050
Mailing Address - Fax:317-770-1645
Practice Address - Street 1:16000 PROSPERITY DR STE 400
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-4322
Practice Address - Country:US
Practice Address - Phone:317-770-1050
Practice Address - Fax:317-770-1645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-22
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty