Love, Randy S

Love, Randy S is an individual health care provider with primary practice located at 1668 W Peace St , Canton MS 39046-5332. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Love, Randy S can be contacted via phone (601) 859-5213.

Contact Information

Primary practice address
1668 W Peace St Canton MS 39046-5332
Phone: (601) 859-5213
Fax: (601) 859-8771
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 1934 81 Mississippi

Profile Details

NPI number 1023228319
LBN Legal business name Love, Randy S
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated Jul 8th, 2007 - about 17 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 1023228319 NPPES
Mississippi MEDICAID 01689068

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