| NPI | 1255497236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NJDEH NICK GHAZARYAN President 818-970-5070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 53702) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2018-03-01 |