Provider Demographics
NPI:1417401308
Name:CENTER FOR ENDODONTICS INC.
Entity Type:Organization
Organization Name:CENTER FOR ENDODONTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VAROOJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRZAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-447-5050
Mailing Address - Street 1:6177 N THESTA ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8600
Mailing Address - Country:US
Mailing Address - Phone:559-447-5050
Mailing Address - Fax:559-447-5057
Practice Address - Street 1:6177 N THESTA ST
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8600
Practice Address - Country:US
Practice Address - Phone:559-447-5050
Practice Address - Fax:559-447-5057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA427861223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty