Individual
AMBER M RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1730 S 13TH ST, MILWAUKEE, WI 53204-3201
(414) 383-3220
Mailing address
1730 S 13TH ST, MILWAUKEE, WI 53204-3201
(414) 383-3220
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1002902
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1002902
LICENSE
WI
Enumeration date
10/20/2020
Last updated
10/20/2020
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