Individual
KATELYN M RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
220 E COLORADO AVE, STE 106, TELLURIDE, CO 81435
(719) 480-3822
Mailing address
PO BOX 4222, TELLURIDE, CO 81435-4222
(719) 480-3822
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
906109
CO
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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