Shoup, Randolph Ken

Shoup, Randolph Ken is an sole proprietor health care provider with primary practice located at 14297 Bergen Blvd # 100 , Noblesville IN 46060-3358. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Shoup, Randolph Ken can be contacted via phone (317) 776-1100.

Contact Information

Primary practice address
14297 Bergen Blvd # 100 Noblesville IN 46060-3358
Fax: (317) 776-1129
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 12008036A Indiana

Profile Details

NPI number 1295741577
LBN Legal business name Shoup, Randolph Ken
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2006
Last updated Oct 22nd, 2008 - about 16 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.

Request for update

Popular Providers