Individual
RANDOLPH L. LA RUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
850 LAKELAND DRIVE, CHIPPEWA FALLS, WI 54729
(715) 738-2000
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4167
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33693900
—
WI
Enumeration date
05/10/2007
Last updated
07/08/2007
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