Individual
RANDOLPH C PEARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
121 W POPLAR ST, STE C, WALLA WALLA, WA 99362-2871
(509) 525-2850
(509) 529-6545
Mailing address
PO BOX 445, WAITSBURG, WA 99361-0445
(509) 337-8881
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4967
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5512702
—
WA
Enumeration date
11/29/2005
Last updated
07/08/2007
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