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General NPI Number Information
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NPI Number | 1568528099
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Entity Type | Organization
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Legal Business Name | ARSEN SUKIASYAN DENTAL CORPORATION
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7000 INDIANA AVE SUITE 117
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City | RIVERSIDE
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State | CA
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Zip | 92506-4154
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Country | US
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Telephone | 951-367-1345
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Fax | 951-367-1347
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Provider Business Mailing Address
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Address Line | 7000 INDIANA AVE SUITE 117
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City | RIVERSIDE
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State | CA
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Zip | 92506-4154
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Country | US
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Telephone | 951-367-1345
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Fax | 951-367-1347
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARSEN SUKIASYAN
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Credential | D.D.S.
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Telephone | 951-367-1345
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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 | 49999
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License Number State | CA
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