Provider Demographics
NPI:1588032650
Name:AMIRIAN DENTAL PC
Entity Type:Organization
Organization Name:AMIRIAN DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YANA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIRIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-562-2042
Mailing Address - Street 1:11 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-2115
Mailing Address - Country:US
Mailing Address - Phone:978-562-2042
Mailing Address - Fax:978-562-2268
Practice Address - Street 1:11 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-2115
Practice Address - Country:US
Practice Address - Phone:978-562-2042
Practice Address - Fax:978-562-2268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty