Organization
RANDALL M STUCKI FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL MCKAY STUCKI DDS (OWNER/PRESIDENT)
(801) 636-5455
Entity
Organization
Contact information
Practice address
75 W MAIN STREET CT STE 200, ALPINE, UT 84004-5602
(801) 636-5455
(801) 492-7728
Mailing address
75 W MAIN STREET CT STE 200, ALPINE, UT 84004-5602
(801) 636-5455
(801) 492-7728
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1454049922
UT
Other
Enumeration date
08/04/2010
Last updated
08/04/2010
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