| Randolph P Platt Dds, Pc | |
|
100 North 13th West St. Johns AZ 85936 | |
| (928) 337-2522 | |
| (928) 337-4881 |
| Full Name | Randolph P Platt Dds, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 North 13th West, St. Johns, Arizona |
| Authorized Official Name and Position | Randolph Patteson Platt (PRESIDENT-OWNER) |
| Authorized Official Contact | 9283372522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randolph P Platt Dds, Pc Po Box 930 St. Johns AZ 85936-0930 Ph: (928) 337-2522 | Randolph P Platt Dds, Pc 100 North 13th West St. Johns AZ 85936 Ph: (928) 337-2522 |
| NPI Number | 1811254246 |
|---|---|
| Provider Enumeration Date | 04/23/2012 |
| Last Update Date | 04/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811254246 | NPI | - | NPPES |
| 081282-001 | Other | AZ | STATE AHCCCS PROGRAM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2706 (Arizona) | Primary |