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Organization
MIDNITE DENTAL, PLLC
Active
Organization
MIDNITE DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KLAUS JOHANN RADTKE DDS (OWNER/DENTIST)
(415) 225-6675
Entity
Organization
Contact information
Practice address
801 E NOLANA AVE, SUITE # 14, MCALLEN, TX 78504-6104
(415) 225-6675
Mailing address
PO BOX 3126, MCALLEN, TX 78502-3126
(415) 225-6675
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
26256
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2804890
—
TX
Enumeration date
07/04/2014
Last updated
04/26/2015
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