Individual
RANDALL K. STUART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
902 ECHO VALE DR, BEDFORD, PA 15522-2010
(814) 623-2217
(814) 623-6271
Mailing address
902 ECHO VALE DR, BEDFORD, PA 15522-2010
(814) 623-2217
(814) 623-6271
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS028687L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017833650001
—
PA
Enumeration date
12/04/2007
Last updated
12/04/2007
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