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Contact Information

GREGORY T RANDALL DDS PC
212 W STATE ROAD
HASTINGS, MI49058
 Phone: 269-948-6684
 Fax: 269-948-4644
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for GREGORY T RANDALL DDS PC

NPI # 1295896942
LBN Legal business name GREGORY T RANDALL DDS PC
Authorized official GREGORY RANDALL - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/13/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MI License # 017159
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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