Individual provider · NPI-1

Carrie MD Randolph, DDS

Dentist, General Practice · Kodiak, AK

NPI number1740594779
StatusActive
Last updated in NPPESSep 30, 2016

Details

NPI
1740594779
Entity type
Individual (NPI-1)
Name
Carrie MD Randolph
Credential
DDS
Sex
Female
Sole proprietor
No
Enumeration date
Aug 2, 2010
Last updated
Sep 30, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice1346AKYes

Practice location

506 W Marine Way
Kodiak, AK 99615-7311

Phone 907-486-3269

Mailing address

506 W Marine Way
Kodiak, AK 99615-7311

Phone 907-486-3269

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dentist, General Practice providers in Kodiak, AK