Provider Demographics
NPI:1922395383
Name:RICHARDSON, WILLIAM EDWARD III (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:RICHARDSON
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 686
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36072-0686
Mailing Address - Country:US
Mailing Address - Phone:334-687-4613
Mailing Address - Fax:
Practice Address - Street 1:150 N ORANGE AVE
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-1620
Practice Address - Country:US
Practice Address - Phone:334-687-4613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL58371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice