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General NPI Number Information
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NPI Number | 1114478203
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Entity Type | Organization
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Legal Business Name | MARIANNA GHULARYAN D.D.S. INC
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 10/24/2016
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Provider Practice Location Address
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Address Line | 1400 N. EDISON BLVD.
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City | BURBANK
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State | CA
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Zip | 91505
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Country | US
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Telephone | 818-233-8787
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Fax | 844-330-0621
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Provider Business Mailing Address
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Address Line | 1400 N. EDISON BLVD.
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City | BURBANK
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State | CA
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Zip | 91505
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Country | US
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Telephone | 818-233-8787
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Fax | 844-330-0621
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Authorized Official
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Title or Position | DENTIST
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Name | MRS. MARIANNA GHULARYAN
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Credential | D.D.S
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Telephone | 818-536-8855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 61407
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License Number State | CA
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