Organization
DENNIS RADFORD OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS S RADFORD O D (OPTOMETRIST)
(208) 525-2090
Entity
Organization
Contact information
Practice address
700 E 17TH ST, IDAHO FALLS, ID 83404-6152
(208) 522-2839
(208) 522-0848
Mailing address
PO BOX 3469, IDAHO FALLS, ID 83403-3469
(208) 525-2090
(208) 525-2662
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100115
ID
Other
Enumeration date
12/05/2007
Last updated
12/05/2007
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