Provider Demographics
NPI:1619223161
Name:'COMFORT DENTAL HYGIENE PRACTICE OF CAROLIE AGHAMALIAN'
Entity Type:Organization
Organization Name:'COMFORT DENTAL HYGIENE PRACTICE OF CAROLIE AGHAMALIAN'
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/REGISTERED DENTAL HYGIENIS
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHAMALIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDHAP, BS
Authorized Official - Phone:818-517-9997
Mailing Address - Street 1:3940 LAUREL CANYON BLVD.
Mailing Address - Street 2:#944
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604
Mailing Address - Country:US
Mailing Address - Phone:818-517-9997
Mailing Address - Fax:818-579-4047
Practice Address - Street 1:3940 LAUREL CANYON BLDV.
Practice Address - Street 2:#944
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604
Practice Address - Country:US
Practice Address - Phone:818-517-9997
Practice Address - Fax:818-579-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty