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NPI Code Detail

MEDICARE: ARYAN DENTAL CORP

MEDICARE: ARYAN DENTAL CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry51531CA

General Provider Information

NPI Number : 1043573157
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARYAN DENTAL CORP
Provider Business Mailing Address
First Line : 4501 MISSION BAY DR STE 2E
Second Line :
City : SAN DIEGO
State : CA
Zip : 92109-4925
Country : US
Telephone Number : 858-270-6626
Fax Number : 585-270-6625
Provider Business Practice Location Address
First Line : 4501 MISSION BAY DR STE 2E
Second Line :
City : SAN DIEGO
State : CA
Zip : 92109-4925
Country : US
Telephone Number : 858-270-6626
Fax Number : 585-270-6625
Authorized Official
Title or Position : PRESIDENT
Name : SONNY ARYAN
Credential :
Telephone Number : 858-270-6626
Provider Enumeration Date : 06/22/2012
Last Update Date : 11/17/2015

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Directions to “ARYAN DENTAL CORP ” Practice Location

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