Provider Demographics
NPI:1164601829
Name:GARO OURFALIAN FAMILY DENTIST
Entity Type:Organization
Organization Name:GARO OURFALIAN FAMILY DENTIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:GARO
Authorized Official - Middle Name:
Authorized Official - Last Name:OURFALIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-343-0013
Mailing Address - Street 1:18455 BURBANK BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6648
Mailing Address - Country:US
Mailing Address - Phone:818-343-0013
Mailing Address - Fax:818-343-0577
Practice Address - Street 1:18455 BURBANK BLVD STE 401
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6648
Practice Address - Country:US
Practice Address - Phone:818-343-0013
Practice Address - Fax:818-343-0577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty