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Organization
EVAZYAN DENTAL CORP
Active
Organization
EVAZYAN DENTAL CORP
Active
Other names
Magnolia Gentle Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENITA EVAZYAN DMD (DENTIST)
(818) 506-0100
Entity
Organization
Contact information
Practice address
12143 MAGNOLIA BLVD, VALLEY VILLAGE, CA 91607-2609
(818) 506-0100
(818) 506-0700
Mailing address
12143 MAGNOLIA BLVD, VALLEY VILLAGE, CA 91607-2609
(818) 506-0100
(818) 506-0700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
43949
CA
122300000X
Dentist
47472
CA
Other
Enumeration date
12/12/2006
Last updated
09/04/2012
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