Individual
SAMRAH RIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2719 CALUMET AVE, MANITOWOC, WI 54220-5546
(920) 686-2333
Mailing address
1801 BURR OAK CT, WAUKESHA, WI 53189-8400
(262) 744-5838
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001852-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
WI
Other
Enumeration date
12/25/2024
Last updated
07/16/2025
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