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General NPI Number Information
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NPI Number | 1770132037
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Entity Type | Organization
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Legal Business Name | MICHAEL AGHELIAN DDS PLLC
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 2005 NEREID AVE
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City | BRONX
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State | NY
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Zip | 10466-1228
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Country | US
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Telephone | 718-426-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 73 HICKS LN
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City | GREAT NECK
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State | NY
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Zip | 11024-2027
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Country | US
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Telephone | 516-849-1439
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. MICHAEL AGHELIAN
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Credential | DDS
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Telephone | 516-849-1439
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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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