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General NPI Number Information
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NPI Number | 1548139553
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Entity Type | Organization
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Legal Business Name | ALANSON M. RANDOL DDS, P.C.
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1100 NW GARDEN VALLEY BLVD
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City | ROSEBURG
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State | OR
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Zip | 97471-1923
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Country | US
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Telephone | 541-673-7437
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 NW GARDEN VALLEY BLVD
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City | ROSEBURG
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State | OR
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Zip | 97471-1923
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALANSON RANDOL
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Credential |
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Telephone | 541-673-7437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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