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Provider Information for 1356694061



MARIANNA GHULARYAN D.D.S.

Gender: FEMALE

Individual NPI: 1356694061

Calendar Last Updated: 2013-02-21

Details

Name Value
NPI 1356694061
Enumeration Date 2012-10-18
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 343 N CHEVY CHASE DR UNIT 5
GLENDALE, CA 91206-6002
United States

Phone: 818-536-8855 | Fax:
View Map External Link
Primary Practice Address 343 N CHEVY CHASE DR UNIT 5
GLENDALE, CA 91206-6002
United States

Phone: 818-536-8855 | Fax:
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 61407
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location