Organization
RANDOLPH SMILES LLC
Active
Other names
Dental Associates Randolph
Organization subpart
No
Provider details
NPI number
Authorized official
RAMESH IZEDIAN DMD (DENTIST)
(508) 676-8268
Entity
Organization
Contact information
Practice address
56 SOUTH MAIN STREET, RANDOLPH, MA 02368
(508) 676-8268
Mailing address
673 ROBESON STREET, FALL RIVER, MA 02720
(508) 676-8268
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18174
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280712
—
MA
Enumeration date
11/08/2016
Last updated
11/08/2016
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