Individual
STEPHEN SMITH RADCLIFFE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
216 JESSIE DUPONT MEMORIAL HIGHWAY, BURGESS, VA 22432-0628
(804) 453-4361
Mailing address
PO BOX 628, BURGESS, VA 22432-0628
(804) 453-4361
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401006554
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401006554
STATE LICENSE NUMBER
VA
Enumeration date
01/23/2006
Last updated
07/08/2007
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