Organization
RANDALL O DUCK DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL OWEN DUCK DDS (PRESIDENT)
(336) 760-2500
Entity
Organization
Contact information
Practice address
3744 VEST MILL RD, WINSTON SALEM, NC 27103-2912
(336) 760-2501
(336) 760-2192
Mailing address
3744 VEST MILL RD, WINSTON SALEM, NC 27103-2912
(336) 760-2501
(336) 760-2192
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4630
NC
Other
Enumeration date
02/09/2008
Last updated
02/09/2008
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