Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. AMIR REZA ARDALAN, DMD
Active Sole ProprietorDR. AMIR REZA ARDALAN, DMD is a Pediatric Dentistry healthcare provider located in PORT ST. LUCIE, Florida. NPI 1093873820 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · PORT ST. LUCIE, FL
Registration Details
- NPI Number
- 1093873820
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 5, 2006 (19.672103750441 yrs)
- Last Updated
- Jul 8, 2007
- License
-
DN16127 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
374 SW PRIMA VISTA BLVD.PORT ST. LUCIE, FL, 34983Browse FL providers · Browse ZIP 34983
- Phone
- 7723444664
- Fax
- 7726214498
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.