Provider Demographics
NPI:1336316090
Name:RADELL, MICHAEL HANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HANK
Last Name:RADELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3900 CLARK ROAD
Mailing Address - Street 2:BLDG A2
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233
Mailing Address - Country:US
Mailing Address - Phone:941-923-1885
Mailing Address - Fax:941-924-5445
Practice Address - Street 1:3900 CLARK ROAD
Practice Address - Street 2:BLDG A2
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233
Practice Address - Country:US
Practice Address - Phone:941-923-1885
Practice Address - Fax:941-924-5445
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL48021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics