Provider Demographics
NPI:1093831745
Name:NARTEA, RANDOLPH J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANDOLPH
Middle Name:J
Last Name:NARTEA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 S MILDRED ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98465-1627
Mailing Address - Country:US
Mailing Address - Phone:253-460-1800
Mailing Address - Fax:253-460-0697
Practice Address - Street 1:1628 S MILDRED ST
Practice Address - Street 2:SUITE 206
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465-1627
Practice Address - Country:US
Practice Address - Phone:253-460-1800
Practice Address - Fax:253-460-0697
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA76081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice