Individual
MR. RADOSTIN ILIEV MLADENOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
15182 N 75TH AVE, SUITE 120, PEORIA, AZ 85381-4722
(623) 878-2400
(623) 878-3151
Mailing address
14195 W AMELIA AVE, GOODYEAR, AZ 85338-8447
(623) 535-8438
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
H6000
AZ
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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