Stettler, Randall Wayne
Stettler, Randall Wayne is an sole proprietor health care provider with primary practice located at 5565 Grossmont Center Dr Building 1, Suite 129, La Mesa CA 91942-3020. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Stettler, Randall Wayne can be contacted via phone (619) 463-4486.Contact Information
Primary practice address
5565 Grossmont Center Dr Building 1, Suite 129
La Mesa CA 91942-3020
Phone: (619) 463-4486
Fax: (619) 463-6553
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 39089 | California |
Profile Details
| NPI number | 1124244686 |
|---|---|
| LBN Legal business name | Stettler, Randall Wayne |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 17th, 2007 |
| Last updated | Dec 30th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124244686 | NPPES |
| California | Other | 39089 | LICENSE |
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