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Organization
IVY AVANESSIAN FUA, DDS, INC
Active
Organization
IVY AVANESSIAN FUA, DDS, INC
Active
Other names
Ivy Avanessian Fua, DDS, INC
Organization subpart
No
Provider details
NPI number
Authorized official
IVY AVANESSIAN FUA (PRESIDENT)
(818) 846-1733
Entity
Organization
Contact information
Practice address
3923 W BURBANK BLVD, BURBANK, CA 91505-2118
(818) 846-1733
Mailing address
3923 W BURBANK BLVD, BURBANK, CA 91505-2118
(818) 846-1733
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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