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1295741577
RANDOLPH KEN SHOUP
NOBLESVILLE, IN
NPI
1295741577
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IN 12008036A)
Enumeration Date
2006-07-31
Last Update Date
2008-10-22
Business Address
Dr. RANDOLPH KEN SHOUP DDS
14297 BERGEN BLVD # 100
NOBLESVILLE, IN 46060-3358
Phone number: 317-776-1100
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Mailing Address
Dr. RANDOLPH KEN SHOUP DDS
14297 BERGEN BLVD # 100
NOBLESVILLE, IN 46060-3358
Phone number: 317-776-1100
Copy
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