| Carrie Randolph D.d.s. Inc. | |
|
506 W Marine Way Kodiak AK 99615-7311 | |
| (907) 486-3269 | |
| Not Available |
| Full Name | Carrie Randolph D.d.s. Inc. |
|---|---|
| Speciality | Dentist |
| Location | 506 W Marine Way, Kodiak, Alaska |
| Authorized Official Name and Position | Carrie Marie Donaldson Randolph (GENERAL DENTIST) |
| Authorized Official Contact | 9074863269 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carrie Randolph D.d.s. Inc. 506 W Marine Way Kodiak AK 99615-7311 Ph: (907) 486-3269 | Carrie Randolph D.d.s. Inc. 506 W Marine Way Kodiak AK 99615-7311 Ph: (907) 486-3269 |
| NPI Number | 1588113187 |
|---|---|
| Provider Enumeration Date | 09/25/2016 |
| Last Update Date | 09/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588113187 | NPI | - | NPPES |
| 1570433 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1346 (Alaska) | Primary |
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