Provider Demographics
NPI:1114101326
Name:NAVASARTIAN, VAZRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:VAZRICK
Middle Name:
Last Name:NAVASARTIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1756 E QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2352
Mailing Address - Country:US
Mailing Address - Phone:559-696-0595
Mailing Address - Fax:559-323-5080
Practice Address - Street 1:24863 W. HAYNE AVE
Practice Address - Street 2:
Practice Address - City:COALING
Practice Address - State:CA
Practice Address - Zip Code:93210
Practice Address - Country:US
Practice Address - Phone:559-935-4900
Practice Address - Fax:559-935-7021
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50330122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist