Provider Demographics
NPI:1295883494
Name:M. MICHELE HARUTUNIAN, DDS, PC
Entity type:Organization
Organization Name:M. MICHELE HARUTUNIAN, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIHAELA
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:HARUTUNIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-538-3800
Mailing Address - Street 1:340 DOGWOOD AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3400
Mailing Address - Country:US
Mailing Address - Phone:516-538-3800
Mailing Address - Fax:
Practice Address - Street 1:340 DOGWOOD AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3400
Practice Address - Country:US
Practice Address - Phone:516-538-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0468991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty