DR. Randall Stephen Wise, DDS

NPI #1548260854 in Lakewood, Colorado

Provider Information

NPI Number: 1548260854
Entity Type: Individual
Name: DR. Randall Stephen Wise, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 28, 2005
Last Updated: Dec 16, 2014

Practice Location

Address: 7373 W JEFFERSON AVE
Address 2: STE 305
City: Lakewood
State: Colorado
ZIP Code: 80235-2038
Phone: (303) 985-1263

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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