Randal Mark Kowalske in Peoria - Dentist
Randal Mark Kowalske - NPI 1669564290
Randal Mark Kowalske is a Dentist in Peoria, Illinois. Randal Mark Kowalske practices all healthcare services and medical treatments related to Dentist. The NPI Number for Randal Mark Kowalske is 1669564290. The last update date is 2007-07-08.
Randal Mark Kowalske's current location address is 3100 N Dries Ln, Peoria, Illinois. You can contact this provider via phone number 3096886646 and fax number 3096886645. The mailing address for Randal Mark Kowalske is 3100 N Dries Ln, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randal Mark Kowalske |
|---|---|
| Address | 3100 N Dries Ln, Peoria, Illinois |
| Phone Number | 3096886646 |
| Fax Number | 3096886645 |
| Sole Proprietor | N |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1669564290 |
|---|---|
| Provider Enumeration Date | 2006-09-29 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3100 N Dries Ln |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616041265 |
| Phone Number | 3096886646 |
| Fax Number | 3096886645 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identification code issued to Randal Mark Kowalske by the Centers for Medicare & Medicaid Services?
The Randal Mark Kowalske has been assigned the NPI (National Provider Identifier) 1669564290 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical address where Randal Mark Kowalske is geographically located?
The Randal Mark Kowalske is physically situated at the following location: 3100 N Dries Ln, Peoria, IL, 616041265.
What is Randal Mark Kowalske's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Randal Mark Kowalske is Dentist, and the corresponding taxonomy classification code for this specialized field is 122300000X.
When was the Randal Mark Kowalske's 1669564290 issued?
The Randal Mark Kowalske's 1669564290 was issued on 2006-09-29.
As of what date were the Randal Mark Kowalske's details last updated?
The information pertaining to the Randal Mark Kowalske, including its address, specialty, and other details, was most recently updated on 2007-07-08.