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Organization
T GHOTANIAN DDS
Active
Organization
T GHOTANIAN DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TINA GHOTANIAN DDS (OWNER)
(626) 792-0001
Entity
Organization
Contact information
Practice address
1370 FOOTHILL BLVD # 102, LA CANADA, CA 91011-2150
(626) 792-0001
Mailing address
1370 FOOTHILL BLVD # 102, LA CANADA, CA 91011-2150
(626) 792-0001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
47079
CA
Other
Enumeration date
10/28/2013
Last updated
10/28/2013
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