Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 23040 | TX |
NPI | 1184796641 |
---|---|
Provider Name | Dr. Artur V Khurshudian |
First Address | Dallas, TX 75230-5425 |
Second Address | Dallas, TX 75211-1925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |