Individual
GREGORY J RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
9141 VILLAGE SHOP DR, SANDY, UT 84094-7722
(801) 727-2626
Mailing address
4358 PHEASANT RIDGE TRL, LEHI, UT 84043-4977
(801) 362-5165
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6986809-9921
UT
Other
Enumeration date
07/07/2006
Last updated
02/02/2011
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