Organization
ANGELA AYZIN DDS AND VAN AYZIN DDS A DENTAL COPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YAN AYZIN DDS (CORPORATE OFFICER)
(818) 240-5800
Entity
Organization
Contact information
Practice address
815 SO CENTRAL AVE, SUITE 10, GLENDALE, CA 91204-2079
(818) 240-5800
(818) 240-5801
Mailing address
815 SO CENTRAL AVE, SUITE 10, GLENDALE, CA 91204-2079
(818) 240-5800
(818) 240-5801
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
34050
CA
122300000X
Dentist
41813
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9296401
—
CA
Enumeration date
12/18/2006
Last updated
08/22/2020
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