Individual
DR. RANDOLPH KELLY FAULK JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1806 DOCTORS DR, SANFORD, NC 27330
(919) 774-9419
(919) 774-1404
Mailing address
1806 DOCTORS DR, SANFORD, NC 27330
(919) 774-9419
(919) 774-1404
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6030
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8992816
—
NC
Enumeration date
05/12/2006
Last updated
07/08/2007
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