Organization
RANDOLPH C. PEARSON, D.D.S., P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDOLPH C. PEARSON (PRESIDENT)
(509) 525-2850
Entity
Organization
Contact information
Practice address
121 W POPLAR ST STE C, WALLA WALLA, WA 99362-2871
(509) 525-2850
(509) 529-6545
Mailing address
121 W POPLAR ST STE C, WALLA WALLA, WA 99362-2871
(509) 525-2850
(509) 529-6545
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4967
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5512702
—
WA
Enumeration date
07/23/2006
Last updated
08/22/2020
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