Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 54233 | CA |
NPI | 1003055377 |
---|---|
Provider Name | Dr. Arby Ananian |
First Address | Burbank, CA 91505-2843 |
Second Address | Burbank, CA 91505-2843 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2009 |
Last Update Date | 24/05/2011 |