Organization
ANDREA S RADABAUGH DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREA S RADABAUGH DDS (OWNER DENTIST)
(530) 333-7853
Entity
Organization
Contact information
Practice address
420 DIVISION AVE, CRAIGMONT, ID 83523
(208) 924-5830
Mailing address
PO BOX 218, CRAIGMONT, ID 83523-0218
(530) 333-7853
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4296
ID
Other
Enumeration date
06/02/2011
Last updated
06/21/2011
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