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General NPI Number Information
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NPI Number | 1508322819
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Entity Type | Individual
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Provider Name | GREGORY ASATRIAN DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 2236 S ATLANTIC BLVD
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City | MONTEREY PARK
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State | CA
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Zip | 91754-6804
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Country | US
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Telephone | 323-404-4436
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Fax |
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Provider Business Mailing Address
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Address Line | 2236 S ATLANTIC BLVD
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City | MONTEREY PARK
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State | CA
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Zip | 91754-6804
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Country | US
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Telephone | 323-404-4436
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2901600803
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 100717
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License Number State | CA
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