Provider Demographics
NPI:1477291870
Name:RAUFOVA, SARVINOZ (DMD)
Entity Type:Individual
Prefix:
First Name:SARVINOZ
Middle Name:
Last Name:RAUFOVA
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 1:320 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-1508
Mailing Address - Country:US
Mailing Address - Phone:215-941-9247
Mailing Address - Fax:
Practice Address - Street 1:759 NEWTOWN YARDLEY RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1747
Practice Address - Country:US
Practice Address - Phone:215-941-9247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0436231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice