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1295894061
MARTIN WINATA LAKSANA
UPLAND, CA
NPI
1295894061
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: CA 35512)
Enumeration Date
2006-12-07
Last Update Date
2007-07-08
Business Address
DR. MARTIN WINATA LAKSANA D.D.S.
130 S MOUNTAIN AVE #G
UPLAND, CA 91786-6268
Phone number: 909-949-7002
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Mailing Address
DR. MARTIN WINATA LAKSANA D.D.S.
130 S MOUNTAIN AVE #G
UPLAND, CA 91786-6268
Phone number: 909-949-7002
Copy
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