| Doctor Name: | DR. DANNA RADCLIFF |
| NPI Number: | 1033382841 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | TX21353 |
| Business Practice Address: | 696 Highway 71 W Building 4, Unit D Bastrop, TX - 786024009 |
| Business Phone Number: | 5123215437 |
| Business Fax Number: | 8883171936 |
| Mailing Address: | 640 S College St, LA GRANGE |
| State: | TX |
| Postal Code: | 789453409 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/12/2008 |
| NPI Last Update Date: | 11/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | TX21353 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |