Provider Demographics
NPI:1841390358
Name:FRONJIAN, AVO HRATCH (DMD)
Entity Type:Individual
Prefix:DR
First Name:AVO
Middle Name:HRATCH
Last Name:FRONJIAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9636 TIERRA GRANDE ST STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6502
Mailing Address - Country:US
Mailing Address - Phone:858-549-4511
Mailing Address - Fax:
Practice Address - Street 1:9636 TIERRA GRANDE ST STE 105
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-6502
Practice Address - Country:US
Practice Address - Phone:858-549-4511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist