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General NPI Number Information
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NPI Number | 1689129215
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Entity Type | Organization
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Legal Business Name | RANDALL I. FURMAN, DDS, PLC
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Dates
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Enumeration Date | 08/24/2016
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Last Update Date | 08/24/2016
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Provider Practice Location Address
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Address Line | 879 LYNNHAVEN PKWY SUITE 109
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7270
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Country | US
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Telephone | 757-468-4684
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Fax | 757-689-2615
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Provider Business Mailing Address
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Address Line | 879 LYNNHAVEN PKWY SUITE 109
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7270
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Country | US
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Telephone | 757-468-4684
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Fax | 757-689-2615
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. RANDALL I FURMAN
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Credential | DDS
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Telephone | 757-468-4684
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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 | 0401005228
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License Number State | VA
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