| NPI | 1659330157 |
|---|---|
| Professional Name | RICHARD INTISO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 122300000X Dentist (Licence: ME DEN3564) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DEN14936) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2007-07-08 |