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General NPI Number Information
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NPI Number | 1427534403
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Entity Type | Individual
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Provider Name | AVETIK RICKY KAZARIAN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2018
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 508 W. ATEN RD.
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City | IMPERIAL
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State | CA
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Zip | 92251
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Country | US
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Telephone | 760-355-4444
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Fax | 760-355-4446
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Provider Business Mailing Address
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Address Line | 508 W. ATEN RD.
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City | IMPERIAL
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State | CA
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Zip | 92251
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Country | US
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Telephone | 818-635-6662
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS106483
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License Number State | CA
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