Evazyan Dental Corp
Dentist in Valley Village, CA. Organization (NPI-2).
NPI number1104987445
StatusActive
Last updated in NPPESSep 4, 2012
Details
- NPI
- 1104987445
- Entity type
- Organization (NPI-2)
- Legal business name
- Evazyan Dental Corp
- Organization subpart
- No
- Enumeration date
- Dec 12, 2006
- Last updated
- Sep 4, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 43949 | CA | Yes |
| 122300000X | Dentist | 47472 | CA |
Other names
- Magnolia Gentle Dentistry (Doing Business As)
Practice location
12143 Magnolia BlvdValley Village, CA 91607-2609
Phone 818-506-0100 · Fax 818-506-0700
Mailing address
12143 Magnolia BlvdValley Village, CA 91607-2609
Phone 818-506-0100 · Fax 818-506-0700
Authorized official
Benita Evazyan
Dentist
8185060100
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All 20 Dentist providers in Valley Village · All 642 providers in Valley Village
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