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General NPI Number Information
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NPI Number | 1790957801
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Entity Type | Organization
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Legal Business Name | BOYAJIAN & BARDAKJIAN DENTAL CORP.
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 3808 W RIVERSIDE DR 307
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City | BURBANK
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State | CA
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Zip | 91505-4325
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Country | US
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Telephone | 818-640-9896
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Fax |
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Provider Business Mailing Address
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Address Line | 3808 W RIVERSIDE DR 307
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City | BURBANK
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State | CA
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Zip | 91505-4325
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Country | US
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Telephone | 818-640-9896
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | RAMONA BENYAMIN
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Credential |
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Telephone | 310-273-7397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 46754
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License Number State | CA
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