Mirza, Razvan Cornel
Mirza, Razvan Cornel is an individual health care provider with primary practice located at 2715 N Main St , Rockford IL 61103-3111. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mirza, Razvan Cornel can be contacted via phone (815) 964-8713.Contact Information
Primary practice address
2715 N Main St
Rockford IL 61103-3111
Phone: (815) 964-8713
Fax: (815) 964-3719
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 019026551 | Illinois |
Profile Details
| NPI number | 1346202918 |
|---|---|
| LBN Legal business name | Mirza, Razvan Cornel |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 6th, 2006 |
| Last updated | May 14th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346202918 | NPPES |
| Illinois | MEDICAID | 9178466 |
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