Organization
ANTRANIG KELLEYAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTRANIG GARY KELLEYAN DDS (OWNER DENTIST)
(626) 960-6616
Entity
Organization
Contact information
Practice address
13734 RAMONA BLVD, BALDWIN PARK, CA 91706-4021
(626) 960-6616
(626) 337-0047
Mailing address
13734 RAMONA BLVD, BALDWIN PARK, CA 91706-4021
(626) 960-6616
(626) 337-0047
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
52409
CA
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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