Andrea S Radabaugh DDS Pllc

NPI #1811281397 in Craigmont, Idaho

Provider Information

NPI Number: 1811281397
Entity Type: Organization
Organization Name: Andrea S Radabaugh DDS Pllc
Primary Specialty: Dentist
Enumeration Date: Jun 2, 2011
Last Updated: Jun 21, 2011

Practice Location

Address: 420 DIVISION AVE
City: Craigmont
State: Idaho
ZIP Code: 83523
Phone: (208) 924-5830

Authorized Official

Name: DR. ANDREA S RADABAUGH, DDS
Title: OWNER DENTIST
Phone: (530) 333-7853

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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