Organization
RANDALLL DAVIS MDM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REYNA E GONZALEZ (OFFICE MANAGER)
(978) 686-8500
Entity
Organization
Contact information
Practice address
14 MYRTLE ST, SOMERVILLE, MA 02145-4312
(857) 498-1353
Mailing address
14 MYRTLE ST, SOMERVILLE, MA 02145-4312
(857) 498-1353
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1856426
MA
Other
Enumeration date
12/05/2013
Last updated
12/05/2013
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