Boggs, Randall T.

Boggs, Randall T. is an sole proprietor health care provider with primary practice located at 3416 W Laskey Rd , Toledo OH 43623-4015. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Boggs, Randall T. can be contacted via phone (419) 473-8885.

Contact Information

Primary practice address
3416 W Laskey Rd Toledo OH 43623-4015
Phone: (419) 473-8885
Fax: (419) 473-9995
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 15815 Ohio

Profile Details

NPI number 1336148824
LBN Legal business name Boggs, Randall T.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2005
Last updated Mar 19th, 2015 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336148824 NPPES
Ohio Other 653400 UNITED CONCORDIA
Ohio MEDICAID 016909 UNITED CONCORDIA
Ohio MEDICAID 005025 UNITED CONCORDIA
Ohio MEDICAID 0390625 UNITED CONCORDIA

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