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General NPI Number Information
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NPI Number | 1396134896
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Entity Type | Organization
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Legal Business Name | VIKTORIA P. TALEBIAN DMD PC
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Dates
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Enumeration Date | 01/21/2015
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Last Update Date | 01/21/2015
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Provider Practice Location Address
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Address Line | 128 HIGHLAND AVENUE SUITE #1
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City | SALEM
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State | MA
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Zip | 01970
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Country | US
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Telephone | 978-745-2533
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Fax | 978-740-3238
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Provider Business Mailing Address
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Address Line | 128 HIGHLAND AVENUE SUITE #1
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City | SALEM
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State | MA
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Zip | 01970
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Country | US
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Telephone | 978-745-2533
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Fax | 978-740-3238
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Authorized Official
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Title or Position | ORTHODONTIST/OWNER
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Name | DR. VIKTORIA P. TALEBIAN
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Credential | DMD
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Telephone | 978-745-2533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 19428
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License Number State | MA
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