| NPI | 1770114829 |
|---|---|
| Other Name | IVY AVANESSIAN FUA, DDS, INC |
| Entity Type | Organization |
| Authorized Contact | IVY AVANESSIAN FUA President 818-846-1733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-01-28 |