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Organization
ROBERTO DER BOGHOSIAN DDS A PROFESSIONAL DENTAL CORPORATION
Active
Organization
ROBERTO DER BOGHOSIAN DDS A PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO DER BOGHOSIAN DDS (PRESIDENT)
(818) 785-7400
Entity
Organization
Contact information
Practice address
6812 WOODMAN AVE, VAN NUYS, CA 91405-4208
(818) 785-7400
(818) 785-7958
Mailing address
6812 WOODMAN AVE, VAN NUYS, CA 91405-4208
(818) 785-7400
(818) 785-7958
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
31245
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G90696
MEDICAL
CA
Enumeration date
12/21/2006
Last updated
03/10/2014
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