Individual provider · Type 1 NPI
Randolph Thomas Travis, DMD
Pediatric Dentistry · Madisonville, KY
NPI number
1407862626
Active
Practice location
1400 Pride Avenue
Madisonville, KY 42431-9108
Fax (270) 821-7401
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dentistry Primary | 1223P0221X | KY. 5141 (KY) |
| Pediatric Dentistry | 1223P0221X | INDIANA 12010320A (KY) |
| Pediatric Dentistry | 1223P0221X | OHIO 30.019661 (OH) |
| General Practice Dentistry | 1223G0001X | 5141 (KY) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Another provider at this address
Other pediatric dentistry providers in Madisonville
About NPI 1407862626
Randolph Thomas Travis, DMD's National Provider Identifier is 1407862626, issued on Jul 31, 2006. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Madisonville, KY. The record was last updated on Jun 12, 2008.