Organization
ORAL SURGERY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE ROBERT RADDATZ DDS (PRESIDENT)
(602) 248-8745
Entity
Organization
Contact information
Practice address
1277 E MISSOURI AVE, #110, PHOENIX, AZ 85014-2915
(602) 248-8745
(602) 248-7939
Mailing address
1277 E MISSOURI AVE, #110, PHOENIX, AZ 85014-2915
(602) 248-8745
(602) 248-7939
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1421
AZ
Other
Enumeration date
10/13/2006
Last updated
08/22/2020
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