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General NPI Number Information
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NPI Number | 1952944639
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Entity Type | Organization
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Legal Business Name | BAGHDASARIAN AND ROSS DENTAL CORPORATION
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 200 S EL MOLINO AVE STE 2
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City | PASADENA
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State | CA
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Zip | 91101-2985
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Country | US
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Telephone | 626-314-3550
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Fax | 626-314-3552
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Provider Business Mailing Address
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Address Line | 200 S EL MOLINO AVE STE 2
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City | PASADENA
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State | CA
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Zip | 91101-2985
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Country | US
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Telephone | 626-314-3550
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Fax | 626-314-3552
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TEODIK BAGHDASARIAN
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Credential | DDS
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Telephone | 818-624-6161
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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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