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General NPI Number Information
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NPI Number | 1912746561
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Entity Type | Individual
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Provider Name | DAVID RADEN DDS
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Gender | Male
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Dates
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Enumeration Date | 05/22/2024
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 16315 MOUNT AIRY RD
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City | SHREWSBURY
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State | PA
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Zip | 17361-1624
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Country | US
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Telephone | 717-759-5063
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Fax |
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Provider Business Mailing Address
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Address Line | 361 BOILER HOUSE RD BLDG 23
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City | PERRY POINT
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State | MD
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Zip | 21902-1103
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS045264
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License Number State | PA
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