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NPI 1497597744

NPI 1497597744 : ANGELA MARTIROSYAN DMD : ROLLING MEADOWS, IL

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General NPI Number Information
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    NPI Number           |    1497597744
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    Entity Type          |    Individual 
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    Provider Name        |    ANGELA MARTIROSYAN DMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/08/2024
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    Last Update Date     |    02/03/2026
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Provider Practice Location Address
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    Address Line         |    2215 ALGONQUIN RD 
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    City                 |    ROLLING MEADOWS
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    State                |    IL
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    Zip                  |    60008-3607
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    Country              |    US
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    Telephone            |    224-735-2279
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2215 ALGONQUIN RD 
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    City                 |    ROLLING MEADOWS
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    State                |    IL
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    Zip                  |    60008-3607
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    Country              |    US
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    Telephone            |    847-520-0770
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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        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    019035113
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    License Number State |    IL
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