| NPI | 1962579219 |
|---|---|
| Former Legal Business Name | M MICHAEL RANDALL DDS PA |
| Entity Type | Organization |
| Authorized Contact | COLLEEN S HULS Office Manager 913-498-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |