| NPI | 1992179006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YEGHISHEH MIRZOYAN Dentist 818-419-0047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 63761) |
| Additional Taxonomies | 122300000X Dentist |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 44534) | |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2022-07-21 |