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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
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 61407