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Organization
RANDOLPH R WEST DDS PLLC
Active
Organization
RANDOLPH R WEST DDS PLLC
Active
Other names
West Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDOPH ROBERT WEST DDS (OWNER)
(817) 454-3463
Entity
Organization
Contact information
Practice address
295 W. BYRON NELSON BLVD, STE 304, ROANOKE, TX 76262
(817) 454-3463
(866) 892-0774
Mailing address
295 W. BYRON NELSON BLVD, STE 304, ROANOKE, TX 76262
(817) 454-3463
(866) 892-0774
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23888
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447412812
NPI TYPE 1
TX
Enumeration date
03/07/2016
Last updated
03/07/2016
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