Provider Demographics
NPI:1467510404
Name:ALLAIN, RANDY J (DDS, FAGD, FI)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:J
Last Name:ALLAIN
Suffix:
Gender:M
Credentials:DDS, FAGD, FI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 S MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-4870
Mailing Address - Country:US
Mailing Address - Phone:248-887-3300
Mailing Address - Fax:248-887-9711
Practice Address - Street 1:1733 S MILFORD RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:MI
Practice Address - Zip Code:48357-4870
Practice Address - Country:US
Practice Address - Phone:248-887-3300
Practice Address - Fax:248-887-9711
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010145451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice