| Bryan Randolph Dds A Professional Dental Corp. | |
|
1954 Del Paso Rd Suite 101 Sacramento CA 95834-7706 | |
| (916) 419-0020 | |
| (916) 419-6787 |
| Full Name | Bryan Randolph Dds A Professional Dental Corp. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1954 Del Paso Rd, Sacramento, California |
| Authorized Official Name and Position | Bryan Randolph (OWNER/DENTIST) |
| Authorized Official Contact | 9164190020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bryan Randolph Dds A Professional Dental Corp. 1954 Del Paso Rd Suite 101 Sacramento CA 95834-7706 Ph: (916) 419-0020 | Bryan Randolph Dds A Professional Dental Corp. 1954 Del Paso Rd Suite 101 Sacramento CA 95834-7706 Ph: (916) 419-0020 |
| NPI Number | 1568884229 |
|---|---|
| Provider Enumeration Date | 01/15/2014 |
| Last Update Date | 01/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568884229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 41779 (California) | Primary |
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