Individual
MR. BRYAN CLARK RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S. , M.S.
Contact information
Practice address
1954 DEL PASO RD, SUITE #101, SACRAMENTO, CA 95834-7706
(916) 419-0020
(916) 419-6787
Mailing address
1954 DEL PASO RD, SUITE #101, SACRAMENTO, CA 95834-7706
(916) 419-0020
(916) 419-6787
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
41779
CA
Other
Enumeration date
12/04/2006
Last updated
11/19/2009
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