Provider Demographics
NPI:1730878380
Name:A. GULESSERIAN DDS, INC
Entity type:Organization
Organization Name:A. GULESSERIAN DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GULESSERIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-559-3444
Mailing Address - Street 1:539 N GLENOAKS BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-3202
Mailing Address - Country:US
Mailing Address - Phone:818-559-3444
Mailing Address - Fax:818-559-3689
Practice Address - Street 1:539 N GLENOAKS BLVD STE 102
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-3202
Practice Address - Country:US
Practice Address - Phone:818-559-3444
Practice Address - Fax:818-559-3689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental