NPI | 1104254374 |
---|---|
Doing Business As | DENTAL SPECIALTY GROUP OF GLENDALE |
Entity Type | Organization |
Authorized Contact | VIC HALAJIAN President 818-416-4776 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 56717) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 58380) |
1223P0300X Dentist, Periodontics (Licence: CA 30624) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 55829) | |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 57793) | |
Enumeration Date | 2013-10-24 |
Last Update Date | 2013-10-24 |