Provider Demographics
NPI:1114226271
Name:RADFORD PEDIATRIC AND FAMILY DENTISTRY
Entity type:Organization
Organization Name:RADFORD PEDIATRIC AND FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RHEA
Authorized Official - Middle Name:E
Authorized Official - Last Name:RADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-340-0625
Mailing Address - Street 1:10223 BROADWAY ST
Mailing Address - Street 2:D-1
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7880
Mailing Address - Country:US
Mailing Address - Phone:713-340-0625
Mailing Address - Fax:713-436-2452
Practice Address - Street 1:10223 BROADWAY ST
Practice Address - Street 2:D-1
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7880
Practice Address - Country:US
Practice Address - Phone:713-340-0625
Practice Address - Fax:713-436-2452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty