| Stephan Moradians DDS a Prof. Corp | |
|
600 W Broadway Ste 120 Glendale CA 91204-1023 | |
| (818) 409-0924 | |
| (818) 409-8940 |
| Full Name | Stephan Moradians DDS a Prof. Corp |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 600 W Broadway Ste 120, Glendale, California |
| Authorized Official Name and Position | Stepan Moradians (OWNER) |
| Authorized Official Contact | 8184090924 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephan Moradians DDS a Prof. Corp 600 W Broadway Ste 120 Glendale CA 91204-1023 Ph: (818) 409-0924 | Stephan Moradians DDS a Prof. Corp 600 W Broadway Ste 120 Glendale CA 91204-1023 Ph: (818) 409-0924 |
| NPI Number | 1578951216 |
|---|---|
| Provider Enumeration Date | 01/05/2015 |
| Last Update Date | 01/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578951216 | NPI | - | NPPES |
| G9378501 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | 34527 (California) | Primary |
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