Individual
DR. BRADLEY CLAYTON RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
104 MUNICIPAL LN, PAW PAW, MI 49079-1425
(269) 657-4001
Mailing address
PO BOX 232, PAW PAW, MI 49079-0232
(269) 657-4001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019821
MI
Other
Enumeration date
06/05/2008
Last updated
06/05/2008
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