MEDICARE: RAZZ ORTHODONTICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1427886894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAZZ ORTHODONTICS

Provider Business Mailing Address
First Line	:	5401 LONG PRAIRIE RD STE 300
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-2212
Country	:	US
Telephone Number	:	972-787-7299
Fax Number	:

Provider Business Practice Location Address
First Line	:	5401 LONG PRAIRIE RD STE 300
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-2212
Country	:	US
Telephone Number	:	972-787-7299
Fax Number	:	972-787-7288

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. DANYELLE MEAGAN RASMUSSEN
Credential	:
Telephone Number	:	972-787-7299

Provider Enumeration Date	:	07/25/2024
Last Update Date	:	07/25/2024

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Directions to “RAZZ ORTHODONTICS ” Practice Location

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