Individual
DR. RANDALL EDMUND ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2677 ELIZABETH LAKE RD, WATERFORD, MI 48328-3290
(248) 682-8811
(248) 682-2701
Mailing address
2677 ELIZABETH LAKE RD, WATERFORD, MI 48328-3290
(248) 682-8811
(248) 682-2701
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901010725
MI
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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