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S Shahnazarians DDS A Professional Corp

Preferred Provider Organization in Pasadena, CA. Organization (NPI-2).

NPI number1043660004
StatusActive
Last updated in NPPESNov 21, 2017

Details

NPI
1043660004
Entity type
Organization (NPI-2)
Legal business name
S Shahnazarians DDS A Professional Corp
Organization subpart
No
Enumeration date
Jun 20, 2016
Last updated
Nov 21, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
305R00000X Preferred Provider Organization57036CAYes

Practice location

859 N Fair Oaks Ave
Unit 120
Pasadena, CA 91103-3076

Phone 626-765-9758 · Fax 626-765-9760

Mailing address

859 N Fair Oaks Ave Ste 120
Pasadena, CA 91103-3078

Phone 626-765-9758 · Fax 626-765-9760

Authorized official

Sevetlana Shahnazarians
Owner/Dentist
6267659758

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