Provider Demographics
NPI:1669098364
Name:RAPOZA, LIZA (DMD)
Entity type:Individual
Prefix:DR
First Name:LIZA
Middle Name:
Last Name:RAPOZA
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 1:130 CARRIAGE CT
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1451
Mailing Address - Country:US
Mailing Address - Phone:610-955-9166
Mailing Address - Fax:
Practice Address - Street 1:880 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-7183
Practice Address - Country:US
Practice Address - Phone:610-279-8001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042742122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty