Organization
RANDALL W. CHAMBERS, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL WAYNE CHAMBERS II DDS (PRESIDENT)
(616) 949-4650
Entity
Organization
Contact information
Practice address
6143 28TH ST SE, GRAND RAPIDS, MI 49546-6941
(616) 949-4650
(616) 949-5377
Mailing address
6143 28TH ST SE, GRAND RAPIDS, MI 49546-6941
(616) 949-4650
(616) 949-5377
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
17046
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598772972
INDIVIDUAL NPI NUMBER
MI
Enumeration date
04/22/2008
Last updated
04/22/2008
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