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General NPI Number Information
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NPI Number | 1184137374
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Entity Type | Organization
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Legal Business Name | PETER A TZENDZALIAN, DDS, PA
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 3608 SHANNON RD STE 205
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City | DURHAM
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State | NC
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Zip | 27707-6344
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Country | US
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Telephone | 919-402-9200
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Fax | 919-287-2525
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Provider Business Mailing Address
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Address Line | PO BOX 110317621
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City | SIOUX FALLS
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State | SD
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Zip | 57186-0001
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Country | US
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Telephone | 919-402-9200
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Fax | 919-287-2525
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER ARTIN TZENDZALIAN
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Credential | DDS
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Telephone | 919-402-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 7236
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License Number State | NC
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