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General NPI Number Information
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NPI Number | 1871142505
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Entity Type | Organization
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Legal Business Name | DR. HARRY H. ELYASSI, D.M.D., INC.
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 221 E GLENOAKS BLVD STE 210
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City | GLENDALE
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State | CA
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Zip | 91207-2165
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Country | US
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Telephone | 818-926-8284
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Fax |
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Provider Business Mailing Address
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Address Line | 221 E GLENOAKS BLVD STE 210
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City | GLENDALE
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State | CA
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Zip | 91207-2165
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Country | US
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Telephone | 818-296-9660
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HARRY HARAPET ELYASSI
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Credential | DMD
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Telephone | 818-296-9660
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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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