Provider Demographics
NPI:1063713246
Name:TROY FAMILY DENTISTRY, LLC
Entity type:Organization
Organization Name:TROY FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUMANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:636-528-4868
Mailing Address - Street 1:128 PROFESSIONAL PARKWAY
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379
Mailing Address - Country:US
Mailing Address - Phone:636-528-4868
Mailing Address - Fax:636-528-4869
Practice Address - Street 1:128 PROFESSIONAL PARKWAY
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MO
Practice Address - Zip Code:63379
Practice Address - Country:US
Practice Address - Phone:636-528-4868
Practice Address - Fax:636-528-4869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty