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Individual

DENNIS L RADKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
72 EAST DIVISION, SPARTA, MI 49345
(616) 887-8228
(616) 887-1850
Mailing address
72 EAST DIVISION, SPARTA, MI 49345
(616) 887-8228
(616) 887-1850

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11670
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4044890
MI
Enumeration date
10/03/2006
Last updated
07/08/2007
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