| Randal J Place | |
|
276 Main St Massena NY 13662-1901 | |
| (315) 769-0942 | |
| Not Available |
| Full Name | Randal J Place |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 276 Main St, Massena, New York |
| Authorized Official Name and Position | Randal J Place (OWNER) |
| Authorized Official Contact | 3157690942 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randal J Place 276 Main St Massena NY 13662-1901 Ph: (315) 769-0942 | Randal J Place 276 Main St Massena NY 13662-1901 Ph: (315) 769-0942 |
| NPI Number | 1609267814 |
|---|---|
| Provider Enumeration Date | 02/10/2015 |
| Last Update Date | 02/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609267814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 044032 (New York) | Primary |