Blaine Radley, DDS is a student in an organized health care education training program in Jacksonville, FL. The provider is 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. Blaine Radley, DDS NPI is 1902483670. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
653 W 8TH ST
JACKSONVILLE, FL
ZIP 32209-511
Phone: (904) 244-2000
The NPI 1902483670 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).
The enumeration date for this NPI number is 3/26/2021 and was last updated on 3/31/2022.