| Dr Charles Jared Randall, DDS | |
|
3285 E. 17th St., Ammon, ID 83406-6758 | |
| (208) 523-3380 | |
| (208) 523-3077 |
| Full Name | Dr Charles Jared Randall |
|---|---|
| Gender | Male |
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3285 E. 17th St., Ammon, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710035829 | NPI | - | NPPES |
| 806122100 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D-3405-OR (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Charles Jared Randall, DDS 3285 E. 17th St., Ammon, ID 83406-6758 Ph: (208) 523-3380 | Dr Charles Jared Randall, DDS 3285 E. 17th St., Ammon, ID 83406-6758 Ph: (208) 523-3380 |
Monika M Attia, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2641 S 25th E, Ammon, ID 83406 Phone: 208-497-0049 | |
Dr. Kory Bingham, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 3299 E 17th St, Ammon, ID 83406 Phone: 208-529-3007 Fax: 208-529-1525 | |
Dr. Jed Karl Zirker, D.D.S Dentist Medicare: Not Enrolled in Medicare Practice Location: 1801 S Ammon Rd, Ammon, ID 83406 Phone: 208-528-7665 Fax: 208-522-9556 | |
Dr. Randall G. Smith, Dentist Medicare: Not Enrolled in Medicare Practice Location: 2805 Eagle Drive, Ammon, ID 83406 Phone: 208-542-1333 Fax: 208-552-7296 | |
Theodore James, DDS Dentist Medicare: Accepting Medicare Assignments Practice Location: 2677 E 17th St Ste 600, Ammon, ID 83406 Phone: 208-705-9652 | |
Mark Marlowe, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2805 Eagle Dr, Ammon, ID 83406 Phone: 208-542-1333 Fax: 208-552-7296 |