Provider Demographics
NPI:1457170482
Name:AVAK AESTHETIC DENTISTRY, CORP
Entity type:Organization
Organization Name:AVAK AESTHETIC DENTISTRY, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GAYANE
Authorized Official - Middle Name:
Authorized Official - Last Name:AVAKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:754-888-2825
Mailing Address - Street 1:298 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4130
Mailing Address - Country:US
Mailing Address - Phone:754-888-2825
Mailing Address - Fax:
Practice Address - Street 1:298 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4130
Practice Address - Country:US
Practice Address - Phone:754-888-2825
Practice Address - Fax:754-291-2868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty