Campbell, Randall L
Campbell, Randall L is an sole proprietor health care provider with primary practice located at 3540 Duluth Park Ln Suite 270, Duluth GA 30096-6674. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Campbell, Randall L can be contacted via phone (770) 497-8010.Contact Information
Primary practice address
3540 Duluth Park Ln Suite 270
Duluth GA 30096-6674
Phone: (770) 497-8010
Fax: (770) 497-8365
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 10305 | Georgia |
Profile Details
| NPI number | 1417173618 |
|---|---|
| LBN Legal business name | Campbell, Randall L |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 17th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417173618 | NPPES |
| Georgia | MEDICAID | 00342372A |
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