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Organization

KODA PLASTIC SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALICIA A RAGHIB MEDICAL ASSISTANT (PRACTICE MANAGER)
(616) 914-8894
Entity
Organization

Contact information

Practice address
9097 E DESERT COVE AVE STE 100, SCOTTSDALE, AZ 85260-6276
(616) 914-8894
(480) 701-4990
Mailing address
9097 E DESERT COVE AVE STE 100, SCOTTSDALE, AZ 85260-6276
(616) 914-8894
(480) 701-4990

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary

Other

Enumeration date
06/05/2024
Last updated
06/12/2024
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