Organization
RYAN RANDOL DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN RANDOL D.D.S. (PRESIDENT)
(541) 671-3716
Entity
Organization
Contact information
Practice address
3993 LAKE GROVE AVE, LAKE OSWEGO, OR 97035-4493
(503) 636-0055
Mailing address
3993 LAKE GROVE AVE, LAKE OSWEGO, OR 97035-4493
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/25/2015
Last updated
03/25/2015
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