Individual
LEE ROBERT RADDATZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1277 E MISSOURI AVE, 110, PHOENIX, AZ 85014-2915
(602) 248-8745
(602) 248-7939
Mailing address
1277 E MISSOURI AVE, 110, PHOENIX, AZ 85014-2915
(602) 248-8745
(602) 248-7939
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
AZ1421
AZ
Other
Enumeration date
07/28/2011
Last updated
07/28/2011
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