Individual
AMIR GHAZAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4021 S FLORIDA AVE, LAKELAND, FL 33813-1623
(863) 837-1087
Mailing address
4021 S FLORIDA AVE, LAKELAND, FL 33813-1623
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN24408
FL
Other
Enumeration date
08/23/2018
Last updated
10/05/2021
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