Organization
PAW PAW FAMILY DENTISTRY, PLC.
Active
Other names
Galesburg Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY CLAYTON RANDALL DDS (OWNER/DENTIST)
(269) 657-4001
Entity
Organization
Contact information
Practice address
32800 E RED ARROW HWY, PAW PAW, MI 49079-9401
(269) 251-2286
Mailing address
32800 E RED ARROW HWY, PO BOX 232, PAW PAW, MI 49079-9401
(269) 251-2286
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019821
MI
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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