NPI 1023201175

Radcliffe Family Dental, LLC

Organisation General Practice Dentistry Gary, IN

Practice location

Address: 1901 Grant Street, Gary, IN 46404-2761
Phone: (219) 880-1430

Authorised official

Name: Trinoda Radcliffe
Title: Owner
Phone: (219) 880-1430

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 12010399A (IN)

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Registry record

NPI: 1023201175
Entity type: Organization
NPI issued: 22 Aug 2007
Record last updated: 25 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.