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General NPI Number Information
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NPI Number | 1497199145
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Entity Type | Organization
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Legal Business Name | JOHN M. ABAJIAN DDS A DENTAL CORPORATION
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Dates
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Enumeration Date | 04/24/2013
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Last Update Date | 04/24/2013
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Provider Practice Location Address
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Address Line | 29219 CANWOOD ST SUITE 250
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City | AGOURA HILLS
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State | CA
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Zip | 91301-1560
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Country | US
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Telephone | 818-991-2626
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Fax | 818-991-0946
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Provider Business Mailing Address
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Address Line | 29219 CANWOOD ST SUITE 250
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City | AGOURA HILLS
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State | CA
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Zip | 91301-1560
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Country | US
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Telephone | 818-991-2626
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Fax | 818-991-0946
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Authorized Official
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Title or Position | CEO
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Name | JOHN M. ABAJIAN
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Credential | DDS
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Telephone | 818-991-2626
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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 |
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License Number State |
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