Provider Demographics
NPI:1053597567
Name:RADULESCU, DIANA M II (DDS)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:M
Last Name:RADULESCU
Suffix:II
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 MAIN ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-6064
Mailing Address - Country:US
Mailing Address - Phone:860-643-5350
Mailing Address - Fax:860-646-5807
Practice Address - Street 1:945 MAIN ST
Practice Address - Street 2:SUITE 302
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-6064
Practice Address - Country:US
Practice Address - Phone:860-643-5350
Practice Address - Fax:860-646-5807
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009720122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist