Randall, Grady S
Randall, Grady S is an individual health care provider with primary practice located at 1179 E Paris Ave Se , Grand Rapids MI 49546-8371. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Randall, Grady S can be contacted via phone (616) 942-9840.Contact Information
Primary practice address
1179 E Paris Ave Se
Grand Rapids MI 49546-8371
Phone: (616) 942-9840
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | DEN.00201849 | Colorado |
| Dental Providers / Pediatric Dentistry | 1223P0221X | 2901022570 | Michigan |
Profile Details
| NPI number | 1609188531 |
|---|---|
| LBN Legal business name | Randall, Grady S |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2010 |
| Last updated | Mar 28th, 2019 - about 5 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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