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Individual

DR. ROBERT TIMOTHY RADEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D., M.S.

Contact information

Practice address
822 A1A N, SUITE 314, PONTE VEDRA BEACH, FL 32082-3260
(904) 273-5770
(904) 273-5720
Mailing address
822 A1A N, SUITE 314, PONTE VEDRA BEACH, FL 32082-3260

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
4098
SC
1223E0200X
Endodontics
Primary
DN17887
FL
1223E0200X
Endodontics
DS030989L
PA

Other

Enumeration date
08/09/2005
Last updated
07/17/2007
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