| Provider / Organization | NPI | Date Certified |
|---|---|---|
| RANDALL SCOTT DE YOUNG | 1104493410 | 2021-06-06 |
Randall Scott De Young is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1104493410. Registration indicates Randall Scott De Young is a provider of access to dentists-general services with a specialization in Dental Providers, Dentist (Dental Providers, Dentist) (Dentist, ) (Dental, ) (Dentist, Dental Providers)
| Entity Type | Individual |
| Provider Name | Dr. Randall Scott De Young DDS |
| Practice Office Address | 4100 W 3RD ST DAYTON, OH US |
| Practice Office Telephone | 6168213851 |
| Mailing Address | 3486 100TH ST SW BYRON CENTER, MI 493159707 US |
| Business Telephone | 6168213851 |
| Code | Practice | License No State |
|---|---|---|
| 122300000X PRIMARY | Access to Dentists-General Dental Providers Dentist Dental Providers Dentist Dentist Dental Dentist Dental Providers | RES.004364
OH |