Individual
DR. RANDALL C SHULTS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MA, PHD
Contact information
Practice address
1200 CORPORATE CENTER WAY, SUITE 100, WELLINGTON, FL 33414-2108
(561) 793-9888
(561) 793-9166
Mailing address
1200 CORPORATE CENTER WAY, SUITE 100, WELLINGTON, FL 33414-2108
(561) 793-9888
(561) 793-9166
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12793
FL
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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