Provider Demographics
NPI:1720257306
Name:MINAS, ARIS (DDS)
Entity type:Individual
Prefix:DR
First Name:ARIS
Middle Name:
Last Name:MINAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 CANADA BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-2840
Mailing Address - Country:US
Mailing Address - Phone:818-396-4884
Mailing Address - Fax:
Practice Address - Street 1:1528 CANADA BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-2840
Practice Address - Country:US
Practice Address - Phone:818-396-4884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55198122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist