Individual
DR. RANDALL SCOTT DE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1869 PORTER ST SW, WYOMING, MI 49519-1709
(616) 532-7601
Mailing address
2709 144TH AVE, DORR, MI 49323-9707
(616) 821-3851
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600996
MI
122300000X
Dentist
RES.004364
OH
Other
Enumeration date
06/06/2021
Last updated
10/07/2022
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