Organization
IVY AVANESSIAN FUA, DDS, INC
Active
Other names
Ivy Avanessian Fua, DDS, INC
Organization subpart
No
Provider details
NPI number
Authorized official
IVY AVANESSIAN FUA (PRESIDENT)
(818) 846-1733
Entity
Organization
Contact information
Practice address
3923 W BURBANK BLVD, BURBANK, CA 91505-2118
(818) 846-1733
Mailing address
3923 W BURBANK BLVD, BURBANK, CA 91505-2118
(818) 846-1733
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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