Provider Demographics
NPI:1215089362
Name:VOIGT, RNDALL WAYNE (DDS, PA)
Entity type:Individual
Prefix:
First Name:RNDALL
Middle Name:WAYNE
Last Name:VOIGT
Suffix:
Gender:M
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 N LOOP 1604 W STE 118
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4629
Mailing Address - Country:US
Mailing Address - Phone:210-479-8779
Mailing Address - Fax:219-479-7903
Practice Address - Street 1:1207 N LOOP 1604 W STE 118
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4629
Practice Address - Country:US
Practice Address - Phone:210-479-8779
Practice Address - Fax:219-479-7903
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15376122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist