Individual
DR. RANDALL LAMAR SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
4089 VAL TECH RD, VALDOSTA, GA 31602-0929
(229) 245-3716
Mailing address
4089 VAL TECH ROAD, VALDOSTA, GA 31602
(229) 245-3716
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
7932
GA
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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