Provider Demographics
NPI:1992879811
Name:FOY, RANDALL CRAWFORD (DDS)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:CRAWFORD
Last Name:FOY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12435 FREMONT DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-6996
Mailing Address - Country:US
Mailing Address - Phone:804-562-6575
Mailing Address - Fax:
Practice Address - Street 1:7229 FOREST AVE STE 105
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3765
Practice Address - Country:US
Practice Address - Phone:804-288-0102
Practice Address - Fax:804-282-6274
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014101591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice