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Individual

DR. MATTHEW RAYMOND RADANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, DDS

Contact information

Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 494-1805
(918) 494-4573
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
(888) 247-0125
(918) 502-8210

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
7455
OK
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
35081
OK
208600000X
Surgery Physician
35081
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200981500A
OK
Enumeration date
08/11/2011
Last updated
12/11/2024
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