| Company Name: | L. RANDY SHELLEY, JR., DMD, PA |
| Employer identification number (EIN): | 57-0809408 |
| EIN Issuing Authority | Brookhaven, NY |
| NAIC Classification: | 621210 |
| NAIC Description: | Offices of Dentists |
| 401k Pension/Benefits registration | L. RANDY SHELLEY, JR., DMD, PA 401k plan information |
The following addresses have been detected as associated with Tax Indentification Number 570809408
| USA Location Address |
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