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General NPI Number Information
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NPI Number | 1497297006
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Entity Type | Organization
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Legal Business Name | BELLA MNATSAKANYAN, D.D.S.
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Dates
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Enumeration Date | 11/14/2016
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Last Update Date | 11/14/2016
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Provider Practice Location Address
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Address Line | 1160 N CENTRAL AVE
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City | GLENDALE
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State | CA
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Zip | 91202-2510
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Country | US
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Telephone | 818-240-0051
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Fax |
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Provider Business Mailing Address
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Address Line | 1160 N CENTRAL AVE
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City | GLENDALE
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State | CA
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Zip | 91202-2510
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Country | US
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Telephone | 818-240-0051
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. BELLA MNATSAKANYAN
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Credential | D.D.S.
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Telephone | 626-710-7910
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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 | 65325
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License Number State | CA
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