MEDICARE: DR. MARTIN ARAMIS GALSTYAN D.D.S.

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
1	1223G0001X	General Practice Dentistry	61923	CA

General Provider Information

NPI Number	:	1467703124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN ARAMIS GALSTYAN D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 909
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91209-0909
Country	:	US
Telephone Number	:	818-497-2389
Fax Number	:

Provider Business Practice Location Address
First Line	:	531 N LOUISE ST
Second Line	:	UNIT 104
City	:	GLENDALE
State	:	CA
Zip	:	91206-2236
Country	:	US
Telephone Number	:	818-497-2389
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2012
Last Update Date	:	09/20/2012

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