Individual
MR. KEITH L RADACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DR.
Contact information
Practice address
2625 W ALAMEDA AVE, SUITE 200, BURBANK, CA 91505
(818) 845-2616
(818) 845-3359
Mailing address
2625 W ALAMEDA AVE, SUITE 200, BURBANK, CA 91505
(818) 845-2616
(818) 845-3359
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D23024
CA
Other
Enumeration date
02/06/2007
Last updated
10/25/2013
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