Provider Demographics
NPI:1851513477
Name:RADZIUN, JAMES ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLEN
Last Name:RADZIUN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 170
Mailing Address - Street 2:
Mailing Address - City:BRAHAM
Mailing Address - State:MN
Mailing Address - Zip Code:55006
Mailing Address - Country:US
Mailing Address - Phone:320-396-4417
Mailing Address - Fax:
Practice Address - Street 1:110 5TH STREET NW
Practice Address - Street 2:
Practice Address - City:BRAHAM
Practice Address - State:MN
Practice Address - Zip Code:55006
Practice Address - Country:US
Practice Address - Phone:320-396-4417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2014-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND9743122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist