Organization
DRS ERIN AND RANDY ELLIOTT PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY H ELLIOTT DMD (DOCTOR OWNER)
(270) 782-0716
Entity
Organization
Contact information
Practice address
120 CALLAWAY COURT, BOWLING GREEN, KY 42103
(270) 782-0716
(270) 746-9603
Mailing address
120 CALLAWAY COURT, BOWLING GREEN, KY 42103
(270) 782-0716
(270) 746-9603
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
7232
KY
1223P0221X
Pediatric Dentistry
Primary
7717
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60-001716
—
KY
Enumeration date
08/29/2006
Last updated
08/22/2020
Update your record
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