Provider Demographics
NPI:1952944639
Name:BAGHDASARIAN AND ROSS DENTAL CORPORATION
Entity type:Organization
Organization Name:BAGHDASARIAN AND ROSS DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TEODIK
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGHDASARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-624-6161
Mailing Address - Street 1:200 S EL MOLINO AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2985
Mailing Address - Country:US
Mailing Address - Phone:626-314-3550
Mailing Address - Fax:626-314-3552
Practice Address - Street 1:200 S EL MOLINO AVE STE 2
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2985
Practice Address - Country:US
Practice Address - Phone:626-314-3550
Practice Address - Fax:626-314-3552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental