Individual
DR. RAQUEL ITA BARANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2060 W 24TH ST, YUMA, AZ 85364-6123
(928) 819-8999
(928) 539-5579
Mailing address
2060 W 24TH ST, YUMA, AZ 85364-6123
(928) 819-8999
(928) 539-5579
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5762
AZ
1223G0001X
General Practice Dentistry
D8123
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
735102
—
AZ
Enumeration date
03/28/2006
Last updated
04/24/2014
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