Provider Demographics
NPI:1023020237
Name:RAZO, MERCEDES F (DDS,MAGD)
Entity Type:Individual
Prefix:DR
First Name:MERCEDES
Middle Name:F
Last Name:RAZO
Suffix:
Gender:F
Credentials:DDS,MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 CANARIOS CT
Mailing Address - Street 2:#210
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-7877
Mailing Address - Country:US
Mailing Address - Phone:619-656-4199
Mailing Address - Fax:619-656-6945
Practice Address - Street 1:885 CANARIOS CT
Practice Address - Street 2:#210
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-7877
Practice Address - Country:US
Practice Address - Phone:619-656-4199
Practice Address - Fax:619-656-6945
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA394681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice