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Organization
15719 VANOWEN ST DENTAL GROUP OF YEGHISHEH MIRZOYAN DDS INC
Active
Organization
15719 VANOWEN ST DENTAL GROUP OF YEGHISHEH MIRZOYAN DDS INC
Active
Other names
15719 Vanowen St dental group of Yeghisheh Mirzoyan DDS INC
Organization subpart
No
Provider details
NPI number
Authorized official
YEGHISHEH MIRZOYAN D.D.S. (PRESIDENT)
(818) 927-3113
Entity
Organization
Contact information
Practice address
15719 VANOWEN ST, VAN NUYS, CA 91406-5030
(818) 419-0047
Mailing address
6440 GREENBUSH AVE, VAN NUYS, CA 91401-1839
(818) 419-0047
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
—
Other
Enumeration date
05/23/2023
Last updated
05/23/2023
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