Individual
DR. AMIR REZA ARDALAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
130 SW CHAMBER CT, PORT ST LUCIE, FL 34986-3496
(772) 344-4664
(772) 621-4498
Mailing address
4416 N HIGHWAY A1A, HUTCHINSON ISLAND, FL 34949-8208
(772) 812-8785
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN16127
FL
Other
Enumeration date
12/05/2006
Last updated
06/05/2026
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