Organization · NPI-2

Antranig Gary Kelleyan DDS INC.

Dentist, General Practice · Monterey Park, CA

NPI number1801035381
StatusActive
Last updated in NPPESFeb 6, 2009

Details

NPI
1801035381
Entity type
Organization (NPI-2)
Legal business name
Antranig Gary Kelleyan DDS INC.
Organization subpart
No
Enumeration date
Feb 6, 2009
Last updated
Feb 6, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice52409CAYes

Practice location

616 N Garfield Ave Ste 404
Monterey Park, CA 91754-1101

Phone 626-280-4122 · Fax 626-280-4124

Mailing address

616 N Garfield Ave Ste 404
Monterey Park, CA 91754-1101

Phone 626-280-4122 · Fax 626-280-4124

Authorized official

Antranig Gary Kelleyan
Ceo
6262804122

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