TJAHJADI KUSUMO-RAHARDJO

ANAHEIM, CA
NPI1245366020
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: CA  49917)
Enumeration Date2007-02-26
Last Update Date2013-05-07
Business Address
-- TJAHJADI KUSUMO-RAHARDJO DDS
222 S EMERALD ST
ANAHEIM, CA 92804-2525
Phone number: 949-769-0495
Mailing Address
-- TJAHJADI KUSUMO-RAHARDJO DDS
222 S EMERALD ST
ANAHEIM, CA 92804-2525
Phone number: 949-769-0495
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