Individual
ARDALAN NABIZADEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1016 MAIN ST, LYNCHBURG, VA 24504-1712
(434) 847-5866
Mailing address
7029 EQUESTRIAN TRL, SUMMERFIELD, NC 27358-9765
(781) 888-0603
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401418467
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2023
Last updated
06/19/2023
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