Randall Smith

NPI 1659412724 · on the registry since 2007 · sole proprietor

Practice

Address: 2805 Eagle Drive
Ammon, ID 83406
Phone: (208) 542-1333
Fax: (208) 552-7296
Organisation at this address: Alligator Orthodontics, Llc
Alligator Pediatric Dentistry ,Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 1223P0221X
1223P0221X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2024-04-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho