Individual
DR. RANDALL STEPHEN WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7373 W JEFFERSON AVE, STE 305, LAKEWOOD, CO 80235-2038
(303) 985-1263
(303) 985-1659
Mailing address
7373 W JEFFERSON AVE, STE 305, LAKEWOOD, CO 80235-2038
(303) 985-1263
(303) 985-1659
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
HDL809
CO
Other
Enumeration date
07/28/2005
Last updated
12/16/2014
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