Provider Demographics
NPI:1871597146
Name:RAEZ, ARLYNN GENISE (DDS)
Entity type:Individual
Prefix:DR
First Name:ARLYNN
Middle Name:GENISE
Last Name:RAEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ARLYNN
Other - Middle Name:GENISE
Other - Last Name:HAINLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3301 OAKWELL COURT
Mailing Address - Street 2:SUITE #103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-1778
Mailing Address - Country:US
Mailing Address - Phone:210-805-8400
Mailing Address - Fax:210-805-8450
Practice Address - Street 1:3301 OAKWELL COURT
Practice Address - Street 2:SUITE #103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-1778
Practice Address - Country:US
Practice Address - Phone:210-805-8400
Practice Address - Fax:210-805-8450
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX141171223P0300X
CA404891223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics