Individual
DR. THOMAS HEAD RADDALL IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
300 LONGWOOD AVENUE, BOSTON CHILDREN'S HOSPITAL - DEPARTMENT OF DENTISTRY, BOSTON, MA 02115
(617) 355-6571
Mailing address
80 FENWOOD ROAD, SUITE 710, BOSTON, MA 02115
(902) 350-1717
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DL14399
MA
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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