# PAW PAW FAMILY DENTISTRY, PLC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Galesburg Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396148342
- **Authorized official:** DR. BRADLEY CLAYTON RANDALL DDS (OWNER/DENTIST)
- **Authorized official phone:** (269) 657-4001

## Contact information

- **Practice address:** 32800 E RED ARROW HWY, PAW PAW, MI 49079-9401
- **Practice address phone:** (269) 251-2286
- **Mailing address:** 32800 E RED ARROW HWY, PO BOX 232, PAW PAW, MI 49079-9401
- **Mailing address phone:** (269) 251-2286

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901019821 | MI | Yes |

## Other

- **Enumeration date:** 10/06/2014
- **Last updated:** 10/06/2014