Individual
LEILY RAZAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3401 MARKET STREET, SUITE#110, PHILADELPHIA, PA 19104
(215) 573-8400
(215) 573-5550
Mailing address
3401 MARKET STREET, SUITE#110, PHILADELPHIA, PA 19104
(215) 573-8400
(215) 573-5550
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS036337
PA
Other
Enumeration date
12/12/2008
Last updated
12/12/2008
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