Provider Demographics
NPI:1578524518
Name:HARUTUNIAN, MIHAELA MICHELE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIHAELA
Middle Name:MICHELE
Last Name:HARUTUNIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 DOGWOOD AVENUE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010
Mailing Address - Country:US
Mailing Address - Phone:516-538-3800
Mailing Address - Fax:516-538-0619
Practice Address - Street 1:340 DOGWOOD AVENUE
Practice Address - Street 2:SUITE 110
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010
Practice Address - Country:US
Practice Address - Phone:516-538-3800
Practice Address - Fax:516-538-0619
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046899122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist