Organization
TER POGHOSSIAN DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VARTAN TER POGHOSSIAN DDS (PRESIDENT)
(818) 246-3736
Entity
Organization
Contact information
Practice address
1128 N BRAND BLVD, GLENDALE, CA 91202-2504
(818) 246-3736
Mailing address
1128 N BRAND BLVD, GLENDALE, CA 91202-2504
(818) 246-3736
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
56017
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023296985
DENTI-CAL
CA
Enumeration date
09/22/2016
Last updated
09/22/2016
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