Healthcare Provider Details

I. General information

NPI: 1750204806
Provider Name (Legal Business Name): RJP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1662 POST RD UNIT B1
WELLS ME
04090-4638
US

IV. Provider business mailing address

2 SEVIGNY AVE
BIDDEFORD ME
04005-9018
US

V. Phone/Fax

Practice location:
  • Phone: 207-646-2520
  • Fax: 207-646-2540
Mailing address:
  • Phone: 207-229-3698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK RANDALL
Title or Position: DENTIST
Credential: DMD
Phone: 207-229-3698