Organization
RANDOLPH DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE CHANEY (SENIOR ACCOUNTANT)
(781) 562-0469
Entity
Organization
Contact information
Practice address
15 WARREN ST, RANDOLPH, MA 02368-4015
(781) 963-3800
(781) 963-6906
Mailing address
15 WARREN ST, RANDOLPH, MA 02368-4015
(781) 963-3800
(781) 963-6906
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11787
MA
Other
Enumeration date
08/08/2012
Last updated
01/17/2019
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