CHARLES JARED RANDALL

AMMON, ID
NPI1710035829
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: ID  D-3405-OR)
Enumeration Date2007-01-08
Last Update Date2009-07-24
Business Address
Dr. CHARLES JARED RANDALL DDS
3285 E. 17TH ST.
AMMON, ID 83406-6758
Phone number: 208-523-3380
Mailing Address
Dr. CHARLES JARED RANDALL DDS
3285 E. 17TH ST.
AMMON, ID 83406-6758
Phone number: 208-523-3380
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