| I J Bayrakdarian Dmd A Professional Corporation | |
|
1450 E Prosperity Ave Ste 101 Tulare CA 93274-8054 | |
| (559) 377-4000 | |
| (559) 479-4736 |
| Full Name | I J Bayrakdarian Dmd A Professional Corporation |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1450 E Prosperity Ave Ste 101, Tulare, California |
| Authorized Official Name and Position | Angie Buruca (MANAGER) |
| Authorized Official Contact | 5593774000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| I J Bayrakdarian Dmd A Professional Corporation 1616 W Shaw Ave Ste A6 Fresno CA 93711-3513 Ph: (559) 377-4000 | I J Bayrakdarian Dmd A Professional Corporation 1450 E Prosperity Ave Ste 101 Tulare CA 93274-8054 Ph: (559) 377-4000 |
| NPI Number | 1558852863 |
|---|---|
| Provider Enumeration Date | 05/22/2018 |
| Last Update Date | 05/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558852863 | NPI | - | NPPES |
| 203643578 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 50037 (California) | Primary |
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