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Organization
MISNER DENTAL CORP
Active
Organization
MISNER DENTAL CORP
Active
Other names
Kids and Family Dental place, Kids Dental Place, Jack Bayramyan Dental Corp
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN URBANOZO (CREDENTIALING MANAGER)
(719) 323-2362
Entity
Organization
Contact information
Practice address
2621 ZOE AVE, SUITE A, HUNTINGTON PARK, CA 90255-4131
(818) 335-2100
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(818) 335-2100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
51044
CA
Other
Enumeration date
07/28/2011
Last updated
07/03/2023
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