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Individual

DR. AMIR SHAHBAZIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1 LAMBERT LIND HWY, SUITE C, WARWICK, RI 02886-1160
(401) 463-7676
(401) 463-8108
Mailing address
1 LAMBERT LIND HWY, SUITE C, WARWICK, RI 02886-1160
(401) 463-7676
(401) 463-8108

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
17290
MA
1223G0001X
General Practice Dentistry
Primary
2328
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8148-3
BLUE CROSS DENTAL
RI
01
9008148
MEDICAL ASSISTANCE PROGRA
RI
Enumeration date
02/15/2007
Last updated
07/08/2007
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