Healthcare Provider Details

I. General information

NPI: 1316018773
Provider Name (Legal Business Name): SOLEDAD RAZURI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5533 E BELL RD BUILDING B, SUITE 115
SCOTTSDALE AZ
85254-1228
US

IV. Provider business mailing address

10390 E BAHIA DR
SCOTTSDALE AZ
85255-8674
US

V. Phone/Fax

Practice location:
  • Phone: 480-216-1964
  • Fax:
Mailing address:
  • Phone: 480-664-0084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberD5758
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: