Individual
GHAZAL GHASSEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 N 12TH ST, RICHMOND, VA 23298-5064
(415) 619-8436
Mailing address
12017 CLUB COMMONS DR, GLEN ALLEN, VA 23059-7028
(415) 619-8436
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401418728
VA
1223P0700X
Prosthodontics
IP2001
WV
Other
Enumeration date
12/13/2020
Last updated
08/30/2024
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