Provider Demographics
NPI:1326043191
Name:VIOLA, RANDALL GENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:GENE
Last Name:VIOLA
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 1:71 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4414
Mailing Address - Country:US
Mailing Address - Phone:603-493-9576
Mailing Address - Fax:
Practice Address - Street 1:1 TRAFALGAR SQ
Practice Address - Street 2:STE 103
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1998
Practice Address - Country:US
Practice Address - Phone:603-880-3000
Practice Address - Fax:603-880-7772
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH22351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice