Most Relevant Information
Provider Data
| NPI Number: | 1003047341 |
| Provider Name: | LYLA A. GAZARIAN-BOUSTANI D.D.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 1223E0200X |
| Specialty: | Dentist |
| License Number: | 56717 |
Most Important Dates
| Enumeration Date: | 08/04/2009 |
| Last Updated: | 08/04/2009 |
Provider Practice Location
230 N MARYLAND AVE
SUITE 206
GLENDALE
CA
912064261
Practice Location Phone/Fax
| Phone: | 8185472804 |
| Fax: |
Provider Mailing Location
4904 VENTURA CANYON AVE
SHERMAN OAKS
CA
914231408
Provider Mailing Phone/Fax
| Phone: | 8186359358 |
| Fax: |