Individual
MARIAM RAZVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3347 GEORGETOWN RD, INDIANAPOLIS, IN 46224-2432
(317) 490-4688
(317) 291-2208
Mailing address
3347 GEORGETOWN RD, INDIANAPOLIS, IN 46224-2432
(317) 490-4688
(317) 291-2208
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008931
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100125700A
—
IN
Enumeration date
01/22/2007
Last updated
11/10/2010
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