Davis, Randall L

Davis, Randall L is an individual health care provider with primary practice located at 100 Amesbury St Ste 203 , Lawrence MA 01840-1321. He recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice, Dental Providers / Prosthodontics. Dental Providers / General Practice is his primary health care specialty. Davis, Randall L can be contacted via phone (978) 686-8500.

Contact Information

Primary practice address
100 Amesbury St Ste 203 Lawrence MA 01840-1321
Phone: (978) 686-8500
Fax: (978) 686-4032
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 16356 Massachusetts
Dental Providers / General Practice 1223G0001X 16356 Massachusetts
Dental Providers / Prosthodontics 1223P0700X 16356 Massachusetts

Profile Details

NPI number 1487781605
LBN Legal business name Davis, Randall L
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2007
Last updated Oct 3rd, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487781605 NPPES
Massachusetts MEDICAID 0280178

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