Individual
MR. GREGORY THOMAS RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
212 W STATE ROAD, STE A, HASTINGS, MI 49058
(269) 948-6684
(269) 948-4644
Mailing address
212 W STATE ROAD, STE A, HASTINGS, MI 49058
(269) 948-6684
(269) 948-4644
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
017159
MI
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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