Provider Demographics
NPI:1891818977
Name:RAZEK, BRIAN G (DDS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:G
Last Name:RAZEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29001 CEDAR ROAD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124
Mailing Address - Country:US
Mailing Address - Phone:440-442-8900
Mailing Address - Fax:440-442-1355
Practice Address - Street 1:29001 CEDAR ROAD
Practice Address - Street 2:SUITE 301
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124
Practice Address - Country:US
Practice Address - Phone:440-442-8900
Practice Address - Fax:440-442-1355
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30017109122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist