Individual
VANA GHAZY BAHRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
40 PITTS SCHOOL RD SW, CONCORD, NC 28027-3931
(704) 461-0707
Mailing address
6025 RUISSEAU ST UNIT 1407, CHARLOTTE, NC 28269-3668
(214) 864-7678
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12987
NC
122300000X
Dentist
38874
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2022
Last updated
09/03/2022
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