Organization
RANDOLPH P PLATT DDS, PC
Active
Other names
Platt Comprehensive Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDOLPH PATTESON PLATT D.D.S. (PRESIDENT-OWNER)
(928) 337-2522
Entity
Organization
Contact information
Practice address
100 NORTH 13TH WEST, ST. JOHNS, AZ 85936
(928) 337-2522
(928) 337-4881
Mailing address
PO BOX 930, ST. JOHNS, AZ 85936-0930
(928) 337-2522
(928) 337-2522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2706
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081282-001
STATE AHCCCS PROGRAM
AZ
Enumeration date
04/23/2012
Last updated
04/23/2012
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