Provider Demographics
NPI:1619007598
Name:ASSATOURIANS, ALBERT (DENTIST)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:ASSATOURIANS
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20263 SATICOY STREET
Mailing Address - Street 2:SUITE F
Mailing Address - City:WINNETKE
Mailing Address - State:CA
Mailing Address - Zip Code:91306
Mailing Address - Country:US
Mailing Address - Phone:818-709-3566
Mailing Address - Fax:818-709-0604
Practice Address - Street 1:20263 SATICOY STREET
Practice Address - Street 2:SUITE F
Practice Address - City:WINNETKE
Practice Address - State:CA
Practice Address - Zip Code:91306
Practice Address - Country:US
Practice Address - Phone:818-709-3566
Practice Address - Fax:818-709-0604
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46020122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist