Provider Demographics
NPI:1336419852
Name:ARMEN HARTOONIAN DENTAL CORP
Entity Type:Organization
Organization Name:ARMEN HARTOONIAN DENTAL CORP
Other - Org Name:BURBANK PROSTHODONTICS & IMPLANT DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTOONIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, CAGS
Authorized Official - Phone:818-566-4438
Mailing Address - Street 1:401 S GLENOAKS BLVD
Mailing Address - Street 2:SUITE NUMBER 100
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1448
Mailing Address - Country:US
Mailing Address - Phone:818-566-4438
Mailing Address - Fax:818-566-4418
Practice Address - Street 1:401 S GLENOAKS BLVD
Practice Address - Street 2:SUITE NUMBER 100
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1448
Practice Address - Country:US
Practice Address - Phone:818-566-4438
Practice Address - Fax:818-566-4418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA590651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty