Provider Demographics
NPI:1346298163
Name:BAGDASARIAN, ARAM A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARAM
Middle Name:A
Last Name:BAGDASARIAN
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 1:7330 N CANTON CENTER RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-1538
Mailing Address - Country:US
Mailing Address - Phone:734-459-4960
Mailing Address - Fax:734-459-5069
Practice Address - Street 1:7330 N CANTON CENTER RD
Practice Address - Street 2:SUITE 109
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1538
Practice Address - Country:US
Practice Address - Phone:734-459-4960
Practice Address - Fax:734-459-5069
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI107781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice