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General NPI Number Information
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NPI Number | 1447828967
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Entity Type | Organization
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Legal Business Name | S KARAKOZIAN & T KOTCHOUNIAN DENTAL CORP
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 1080 WILSHIRE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90017-2416
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Country | US
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Telephone | 818-667-0624
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Fax |
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Provider Business Mailing Address
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Address Line | 956 BIG BRIAR WAY
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City | LA CANADA
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State | CA
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Zip | 91011-1817
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Country | US
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Telephone | 818-667-0624
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TALINE KOTCHOUNIAN
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Credential | DDS
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Telephone | 818-667-0624
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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 |
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License Number State |
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