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Individual
RANDY DEMETTER
Active
Individual
RANDY DEMETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D-4831-PE
ID
1223P0300X
Periodontics
ETN283
TX
Other
Enumeration date
07/23/2014
Last updated
04/05/2023
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