Organization
CARRIE RANDOLPH D.D.S. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE MARIE DONALDSON RANDOLPH D.D.S. (GENERAL DENTIST)
(907) 486-3269
Entity
Organization
Contact information
Practice address
506 W MARINE WAY, KODIAK, AK 99615-7311
(907) 486-3269
Mailing address
506 W MARINE WAY, KODIAK, AK 99615-7311
(907) 486-3269
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1346
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1570433
—
AK
Enumeration date
09/25/2016
Last updated
09/25/2016
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