Individual provider · Type 1 NPI

Blaine Radley, DDS

Student in an Organized Health Care Education/Training Program · Jacksonville, FL

NPI number 1902483670 Active

Practice location

653 W 8th St
Jacksonville, FL 32209-6511

Call (904) 244-2000 Map

Mailing address

653 W 8th St Fl 32209
Jacksonville, FL 32209-6511

Other practice locations

  • 3400 Spruce St, Philadelphia, PA 19104-4238 · (215) 316-5151

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1902483670

Blaine Radley, DDS's National Provider Identifier is 1902483670, issued on Mar 26, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Jacksonville, FL. The record was last updated on Mar 31, 2022.