Individual
DR. C. RANDALL DOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1456 KADERLY ST NW, NEW PHILADELPHIA, OH 44663-1243
(330) 364-8665
(330) 364-8667
Mailing address
1456 KADERLY ST NW, NEW PHILADELPHIA, OH 44663-1243
(330) 364-8665
(330) 364-8667
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
15013
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
15013
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0472653
—
OH
01
—
43-00059
UNITED HEALTHCARE
OH
01
—
487716
UNITED CONCORDIA
OH
Enumeration date
02/27/2006
Last updated
02/08/2011
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