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General NPI Number Information
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NPI Number | 1043462658
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Entity Type | Individual
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Provider Name | TALAR GULDALIAN
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Gender | Female
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 304 CAMBRIDGE RD STE 340
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City | WOBURN
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State | MA
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Zip | 01801-6033
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Country | US
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Telephone | 781-369-5722
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Fax |
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Provider Business Mailing Address
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Address Line | 315 MIDDLESEX RD UNIT 2
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City | TYNGSBORO
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State | MA
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Zip | 01879-1028
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Country | US
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Telephone | 978-649-3304
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 22047
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License Number State | MA
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