Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 22047 | MA |
NPI | 1043462658 |
---|---|
Provider Name | Talar Guldalian |
First Address | Tyngsboro, MA 01879-1028 |
Second Address | Woburn, MA 01801-6033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2008 |
Last Update Date | 24/08/2018 |