Individual
SHAHAB ARDALAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6040 N 43RD AVE, SUITE #4, GLENDALE, AZ 85301-5488
(623) 218-2222
(623) 218-2221
Mailing address
6040 N 43RD AVE, SUITE #4, GLENDALE, AZ 85301-5488
(623) 218-2222
(623) 218-2221
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5562
AZ
Other
Enumeration date
11/09/2005
Last updated
07/08/2007
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