Provider Demographics
NPI:1497706246
Name:ADOMIAN, GARO JAMES (DR)
Entity Type:Individual
Prefix:
First Name:GARO
Middle Name:JAMES
Last Name:ADOMIAN
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 467 1704
Mailing Address - Street 2:
Mailing Address - City:APO AE
Mailing Address - State:NV
Mailing Address - Zip Code:09096
Mailing Address - Country:US
Mailing Address - Phone:016-096-7787
Mailing Address - Fax:
Practice Address - Street 1:CMR 467 1704
Practice Address - Street 2:
Practice Address - City:APO AE
Practice Address - State:NV
Practice Address - Zip Code:09096
Practice Address - Country:US
Practice Address - Phone:016-096-7787
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53186122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist