# GREGORY T RANDALL DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hastings Family Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295896942
- **Authorized official:** MR. GREGORY THOMAS RANDALL DDS (PRESIDENT)
- **Authorized official phone:** (269) 948-6684

## Contact information

- **Practice address:** 212 W STATE ROAD, HASTINGS, MI 49058
- **Practice address phone:** (269) 948-6684
- **Practice address fax:** (269) 948-4644
- **Mailing address:** 212 W STATE ROAD, STE A, HASTINGS, MI 49058
- **Mailing address phone:** (269) 948-6684
- **Mailing address fax:** (269) 948-4644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 017159 | MI | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 08/22/2020