Provider Demographics
NPI:1720798366
Name:PARVEZ, IFAZ B (DDS)
Entity Type:Individual
Prefix:DR
First Name:IFAZ
Middle Name:B
Last Name:PARVEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 HUGH SHELTON LOOP APT 201
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-3491
Mailing Address - Country:US
Mailing Address - Phone:954-854-2293
Mailing Address - Fax:
Practice Address - Street 1:8159 RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-5981
Practice Address - Country:US
Practice Address - Phone:910-208-4254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC130711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice