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Organization
PAW PAW FAMILY DENTISTRY, PLC.
Active
Organization
PAW PAW FAMILY DENTISTRY, PLC.
Active
Other names
Galesburg Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY CLAYTON RANDALL DDS (OWNER/DENTIST)
(269) 657-4001
Entity
Organization
Contact information
Practice address
32800 E RED ARROW HWY, PAW PAW, MI 49079-9401
(269) 251-2286
Mailing address
32800 E RED ARROW HWY, PO BOX 232, PAW PAW, MI 49079-9401
(269) 251-2286
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019821
MI
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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