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General NPI Number Information
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NPI Number | 1689944225
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Entity Type | Organization
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Legal Business Name | RANDAL P. GARVEY, DDS, LLC
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 815 N WATER ST
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City | UHRICHSVILLE
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State | OH
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Zip | 44683-1457
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Country | US
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Telephone | 740-922-3061
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Fax |
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Provider Business Mailing Address
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Address Line | 815 N WATER ST
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City | UHRICHSVILLE
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State | OH
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Zip | 44683-1457
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Country | US
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Telephone | 740-922-3061
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RANDAL P GARVEY
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Credential | DDS
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Telephone | 937-834-2252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.014812
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License Number State | OH
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