DR. Randolph Ken Shoup, DDS
NPI #1295741577 in Noblesville, Indiana
Provider Information
- NPI Number
- 1295741577
- Entity Type
- Individual
- Name
- DR. Randolph Ken Shoup, DDS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Jul 31, 2006
- Last Updated
- Oct 22, 2008
Practice Location
- Address
- 14297 BERGEN BLVD # 100
- City
- Noblesville
- State
- Indiana
- ZIP Code
- 46060-3358
- Phone
- (317) 776-1100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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