# DR. MHER GRIGORYAN DDS DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992232615
- **Authorized official:** DR. MHER GRIGORYAN (PRESIDENT)
- **Authorized official phone:** (747) 272-9649

## Contact information

- **Practice address:** 2036 LINCOLN AVE, PASADENA, CA 91103-1323
- **Practice address phone:** (747) 272-9649
- **Mailing address:** 2036 LINCOLN AVE, PASADENA, CA 91103-1323
- **Mailing address phone:** (747) 272-9649

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 53219 | CA | Yes |

## Other

- **Enumeration date:** 05/11/2017
- **Last updated:** 06/16/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000532190 | — | CA |