Individual
ALI RAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5011 VERNON BLVD, LONG ISLAND CITY, NY 11101-6511
(989) 327-3822
Mailing address
201 50TH AVE APT 25E, LONG ISLAND CITY, NY 11101-5782
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
062744
NY
Other
Enumeration date
06/22/2021
Last updated
02/19/2024
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