Randolph Dental Group LLC

NPI #1972067072 in Randolph, Massachusetts

Provider Information

NPI Number: 1972067072
Entity Type: Organization
Organization Name: Randolph Dental Group LLC
Subpart: Yes (part of a larger organization)
Parent Organization: RANDOLPH DENTAL GROUP LLC
Primary Specialty: Dentist
Enumeration Date: Jan 23, 2019
Last Updated: Jan 23, 2019

Practice Location

Address: 1 FRANK LEARY WAY UNIT 4
City: Randolph
State: Massachusetts
ZIP Code: 02368-4503
Phone: (781) 963-7204

Authorized Official

Name: JANE CHANEY
Title: SENIOR ACCOUNTANT
Phone: (781) 562-0469

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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