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General NPI Number Information
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NPI Number | 1942214937
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Entity Type | Individual
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Provider Name | WARREN RADCLIFFE DDS
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1092 ROUTE 9
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City | QUEENSBURY
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State | NY
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Zip | 12804
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Country | US
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Telephone | 518-798-9561
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Fax |
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Provider Business Mailing Address
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Address Line | 1745 RT 73 PO BOX 72
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City | KEENE VALLEY
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State | NY
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Zip | 12943
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Country | US
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Telephone | 518-576-9222
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 051928
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License Number State | NY
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