Organization
REZA ARDALAN DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY M ARDALAN (CFO)
(772) 344-4664
Entity
Organization
Contact information
Practice address
130 SW CHAMBER CT, PORT SAINT LUCIE, FL 34986-3496
(772) 344-4664
(772) 621-4498
Mailing address
130 SW CHAMBER CT, PORT SAINT LUCIE, FL 34986-3496
(772) 344-4664
(772) 621-4498
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
06/05/2026
Last updated
06/05/2026
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