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Individual

MR. RANDY L TOWNSEND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LD

Contact information

Practice address
1228 MAIN ST, SWEET HOME, OR 97386-1608
(541) 409-2499
Mailing address
1228 MAIN ST, SWEET HOME, OR 97386-1608

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DTDO629849
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DT.DO-629849
DENTURIST ID. NUMBER
OR
Enumeration date
03/28/2007
Last updated
07/08/2007
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