DR. GREGORY MARSHALL RANDOLPH DD.S. NPI 1801937222

NPI Information

DR. Gregory Marshall Randolph, D,D.S. is a general practice dentist in Bloomington, IL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Gregory Marshall Randolph, D,D.S. NPI is 1801937222. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

119 N WILLIAMSBURG DR
BLOOMINGTON, IL
ZIP 61704-528
Phone: (309) 663-1326
Fax: (309) 662-3551

The enumeration date for this NPI number is 2/9/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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