Individual
MR. RANDALL B MAYBERRY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2074 S 6TH ST, KLAMATH FALLS, OR 97601-3372
(541) 851-8110
(541) 851-8114
Mailing address
893 ROSEMONT CT, KLAMATH FALLS, OR 97603-7154
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8549
OR
Other
Enumeration date
09/19/2005
Last updated
03/07/2023
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