Provider Demographics
NPI:1710338199
Name:ARUTIAN, DENNIS MARK (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:MARK
Last Name:ARUTIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 MARIN ST STE 190
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4104
Mailing Address - Country:US
Mailing Address - Phone:805-230-1967
Mailing Address - Fax:805-230-1965
Practice Address - Street 1:555 MARIN ST STE 190
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4104
Practice Address - Country:US
Practice Address - Phone:805-230-1967
Practice Address - Fax:805-230-1965
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28840122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist