Carrie Randolph D.d.s. Inc.

NPI #1588113187 in Kodiak, Alaska

Provider Information

NPI Number: 1588113187
Entity Type: Organization
Organization Name: Carrie Randolph D.d.s. Inc.
Primary Specialty: Dentist
Enumeration Date: Sep 25, 2016
Last Updated: Sep 25, 2016

Practice Location

Address: 506 W MARINE WAY
City: Kodiak
State: Alaska
ZIP Code: 99615-7311
Phone: (907) 486-3269

Authorized Official

Name: CARRIE MARIE DONALDSON RANDOLPH, D.D.S.
Title: GENERAL DENTIST
Phone: (907) 486-3269

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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