DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. RANDOLPH THOMAS TRAVIS, DMD

Active Sole Proprietor

DR. RANDOLPH THOMAS TRAVIS, DMD is a Pediatric Dentistry healthcare provider located in MADISONVILLE, Kentucky. NPI 1407862626 is currently active in the NPPES registry. Verify at CMS.

Pediatric Dentistry · MADISONVILLE, KY

Registration Details

NPI Number
1407862626
Provider Type
Individual
Gender
Male
NPI Issued
Jul 31, 2006 (20.00426992096 yrs)
Last Updated
Jun 12, 2008
Licenses
KY. 5141 (KY)
INDIANA 12010320A (KY)
OHIO 30.019661 (OH)
5141 (KY)
Sole Proprietor
Yes

Practice Information

Address
1400 PRIDE AVENUE
MADISONVILLE, KY, 424319108
Browse KY providers · Browse ZIP 42431
Phone
2708217386
Fax
2708217401
Primary Specialty
Pediatric Dentistry
1223P0221X
Additional Specialty
Pediatric Dentistry
Additional Specialty
Pediatric Dentistry
Additional Specialty
General Dentistry

Other Pediatric Dentistry Providers in MADISONVILLE, KY

Name Credential NPI
DR. VAUGHN ELLIOT BRUMMER D.D.S. 1548335433
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.