Individual provider · NPI-1

Rusul Abdulrazzaq, DDS

Dentist · Providence, RI

NPI number1235979923
StatusActive
Last updated in NPPESJun 5, 2024

Details

NPI
1235979923
Entity type
Individual (NPI-1)
Name
Rusul Abdulrazzaq
Credential
DDS
Sex
Female
Sole proprietor
No
Enumeration date
May 29, 2024
Certification date
Jun 5, 2024
Last updated
Jun 5, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X DentistDEN03720RIYes

Practice location

335r Prairie Ave
Providence, RI 02905-2426

Phone 401-444-0430 · Fax 401-444-0489

Mailing address

375 Allens Ave
Providence, RI 02905-5010

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