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Contact Information

DAVID J RANDALL, DDS
818 BRADEN AVENUE
CHARITON, IA50049
 Phone: 641-774-2912
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for DAVID J RANDALL · (Male)

NPI # 1710019054
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 03/12/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • IA License # 5524
  • IA Medicaid 0146399
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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