Organization
K. SHAGRAMANOVA DENTAL CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTINA SHAGRAMANOVA DDS (CEO)
(818) 636-9208
Entity
Organization
Contact information
Practice address
3175 FIRESTONE BLVD # 201, SOUTH GATE, CA 90280-2951
(323) 749-0137
(323) 749-0334
Mailing address
410 W COLORADO ST, GLENDALE, CA 91204-1504
(818) 956-9907
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
05/28/2019
Last updated
05/28/2019
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