| NPI | 1720663487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARMEN BALASANYAN Partner 980-275-0099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-03-15 |
| Last Update Date | 2021-03-15 |