Provider Demographics
NPI:1639444193
Name:TAROIAN DENTAL CORPORATION
Entity Type:Organization
Organization Name:TAROIAN DENTAL CORPORATION
Other - Org Name:RESEDA DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HARMICK
Authorized Official - Middle Name:
Authorized Official - Last Name:TAROIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-344-8338
Mailing Address - Street 1:18437 SATICOY ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-2911
Mailing Address - Country:US
Mailing Address - Phone:818-344-8338
Mailing Address - Fax:818-344-8339
Practice Address - Street 1:18437 SATICOY ST
Practice Address - Street 2:SUITE 1
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-2911
Practice Address - Country:US
Practice Address - Phone:818-344-8338
Practice Address - Fax:818-344-8339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52117305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization