Individual
DR. JOSEPH J RADAKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5050 NE HOYT ST, SUITE 322, PORTLAND, OR 97213
(503) 230-0322
(503) 230-0344
Mailing address
5050 NE HOYT ST, SUITE 322, PORTLAND, OR 97213
(503) 230-0322
(503) 230-0344
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D6195
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
931090894
TAX ID
OR
Enumeration date
07/26/2006
Last updated
07/08/2007
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