Individual
FARZIN GHANAVATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14757 CANDLEWOOD CT, WOODBRIDGE, VA 22191-3107
(310) 208-9251
(310) 208-9251
Mailing address
14757 CANDLEWOOD CT, WOODBRIDGE, VA 22191-3107
(310) 208-9251
(310) 208-9251
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401415788
VA
Other
Enumeration date
08/02/2017
Last updated
07/21/2022
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