| NPI | 1558053025 |
|---|---|
| Former Legal Business Name | 15719 VANOWEN ST DENTAL GROUP OF YEGHISHEH MIRZOYAN DDS INC |
| Entity Type | Organization |
| Authorized Contact | YEGHISHEH MIRZOYAN President 818-927-3113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-05-23 |