Individual
DR. RANDALL STEVEN CORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
801 N HUNTINGTON ST, SUITE 11, SYRACUSE, IN 46567-1151
(574) 269-9681
Mailing address
2400 WINONA AVE, UNIT H, WINONA LAKE, IN 46590-2122
(574) 269-9681
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007293A
IN
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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