Individual
KHACHIK TARAKHCHYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13947 ARCHWOOD ST, VAN NUYS, CA 91405-4821
(818) 800-0828
Mailing address
13947 ARCHWOOD ST, VAN NUYS, CA 91405-4821
(818) 800-0828
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HAP790
CA
Other
Enumeration date
12/28/2021
Last updated
12/28/2021
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