Provider Demographics
NPI:1124260104
Name:GARMESTANI, AREZOU (DMD)
Entity type:Individual
Prefix:
First Name:AREZOU
Middle Name:
Last Name:GARMESTANI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 IMPERIAL BLVD
Mailing Address - Street 2:STE C2
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4689
Mailing Address - Country:US
Mailing Address - Phone:863-619-8836
Mailing Address - Fax:863-607-9099
Practice Address - Street 1:215 IMPERIAL BLVD
Practice Address - Street 2:STE C2
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4689
Practice Address - Country:US
Practice Address - Phone:863-619-8836
Practice Address - Fax:863-607-9099
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0014852122300000X
VA0401416294122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist