Provider Demographics
NPI:1992340301
Name:GARO ADOMIAN DDS INC
Entity type:Organization
Organization Name:GARO ADOMIAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARO
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ADOMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-841-0112
Mailing Address - Street 1:2601 W ALAMEDA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4808
Mailing Address - Country:US
Mailing Address - Phone:818-841-0112
Mailing Address - Fax:
Practice Address - Street 1:2601 W ALAMEDA AVE STE 102
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4808
Practice Address - Country:US
Practice Address - Phone:818-841-0112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental