Provider Demographics
NPI:1083272173
Name:RIZK, CHRISTINA (DMD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:RIZK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SWANS WAY
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:K1J6J2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:190 PARK AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2910
Practice Address - Country:US
Practice Address - Phone:617-899-4677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program