SANTOSO TIRTAWIDJAJA

LOS ANGELES, CA
NPI1295896850
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: CA  38931)
Enumeration Date2006-12-13
Last Update Date2007-07-08
Business Address
Dr. SANTOSO TIRTAWIDJAJA DDS
1200 WEST MARTIN LUTHER KING BLVD
LOS ANGELES, CA 90037
Phone number: 323-295-8306
Mailing Address
Dr. SANTOSO TIRTAWIDJAJA DDS
541 DE SALES ST
SAN GABRIEL, CA 91775-2135
Phone number:
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