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1568024347
JAKE RICHARDSON
FORT DUCHESNE, UT
NPI
1568024347
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: UT 11308205-9921)
Enumeration Date
2019-07-02
Last Update Date
2019-07-02
Business Address
JAKE RICHARDSON D.M.D.
6932 E 1400 S
FORT DUCHESNE, UT 84026
Phone number: 435-722-5122
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Mailing Address
JAKE RICHARDSON D.M.D.
412 E 2500 N
VERNAL, UT 84078-9595
Phone number: 435-828-8801
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