Individual
TIGRAN AVETISYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
131 MERRIMACK ST, LOWELL, MA 01852-1723
(978) 788-9338
(978) 225-2591
Mailing address
428 LOWELL ST, LEXINGTON, MA 02420-2234
(616) 780-4642
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1857776
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811901473
—
MA
Enumeration date
10/12/2017
Last updated
02/28/2023
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