Radcliffe Family Dental, LLC

NPI #1023201175 in Gary, Indiana

Provider Information

NPI Number: 1023201175
Entity Type: Organization
Organization Name: Radcliffe Family Dental, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 22, 2007
Last Updated: Jul 25, 2008

Practice Location

Address: 1901 GRANT STREET
City: Gary
State: Indiana
ZIP Code: 46404-2761
Phone: (219) 880-1430

Authorized Official

Name: TRINODA RADCLIFFE, DDS
Title: OWNER
Phone: (219) 880-1430

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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