HERAWATI TIRTADJAJA KANDOU

ELIZABETH, NJ
NPI1023246105
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: NJ  9708)
Additional Taxonomies1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: NJ  3026)
Enumeration Date2009-06-26
Last Update Date2009-06-26
Business Address
Dr. HERAWATI TIRTADJAJA KANDOU DDS
35 JEFFERSON AVENUE
ELIZABETH, NJ 07201-2425
Phone number: 908-354-1188
Mailing Address
Dr. HERAWATI TIRTADJAJA KANDOU DDS
35 JEFFERSON AVENUE
ELIZABETH, NJ 07201-2425
Phone number: 908-354-1188