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 |