| David F Randolph Dmd Pa | |
|
1779 Sw Barnett Way Ste 101 Lake City FL 32025-6957 | |
| (386) 755-4033 | |
| (386) 755-2581 |
| Full Name | David F Randolph Dmd Pa |
|---|---|
| Speciality | Dentist |
| Location | 1779 Sw Barnett Way Ste 101, Lake City, Florida |
| Authorized Official Name and Position | David F Randolph (DENTIST) |
| Authorized Official Contact | 3867554033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David F Randolph Dmd Pa 1779 Sw Barnett Way Ste 101 Lake City FL 32025-6957 Ph: (386) 755-4033 | David F Randolph Dmd Pa 1779 Sw Barnett Way Ste 101 Lake City FL 32025-6957 Ph: (386) 755-4033 |
| NPI Number | 1528189446 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 09/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528189446 | NPI | - | NPPES |
| 60390 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9899 (Florida) | Primary |
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