Randal Mark Kowalske DMD

NPI 1669564290 - Dentist - 122300000X

NPI Details
NPI 1669564290
Gender Male
Enumeration Date 09/29/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
3100 N DRIES LN
SUITE 301
PEORIA IL, 61604-1265, US
Phone (309) 688-6646
Fax (309) 688-6645
Business Location
3100 N DRIES LN
SUITE 301
PEORIA IL, 61604-1265, US
Phone (309) 688-6646
Fax (309) 688-6645
Toxanomy
Taxonomy Code 122300000X
License State
License Number
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According to our database, Randal Mark Kowalske DMD NPI is 1669564290, taxonomy code is 122300000X Randal Mark Kowalske DMD physically located at 3100 N Dries Ln, Peoria IL, 61604-1265. NPI Number Randal Mark Kowalske DMD has the Individual type.

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1669564290 NPI number is provided on an as is basis without warranty of any kind. 1669564290 is maintained by the National Plan & Provider Enumeration System. The contents of Randal Mark Kowalske DMD are for informational purposes only.