Ardalan, Amir Reza
Ardalan, Amir Reza is an sole proprietor health care provider with primary practice located at 374 Sw Prima Vista Blvd. , Port St. Lucie FL 34983. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Ardalan, Amir Reza can be contacted via phone (772) 344-4664.Contact Information
Primary practice address
374 Sw Prima Vista Blvd.
Port St. Lucie FL 34983
Phone: (772) 344-4664
Fax: (772) 621-4498
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | DN16127 | Florida |
Profile Details
| NPI number | 1093873820 |
|---|---|
| LBN Legal business name | Ardalan, Amir Reza |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
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