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1508901257
ANDRE WIDODO
POMONA, CA
NPI
1508901257
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA 46152)
Enumeration Date
2007-02-20
Last Update Date
2022-04-25
Business Address
Dr. ANDRE WIDODO DDS
2112 S GAREY AVE STE A
POMONA, CA 91766-5600
Phone number: 909-590-5600
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Mailing Address
Dr. ANDRE WIDODO DDS
2112 S GAREY AVE STE A
POMONA, CA 91766-5600
Phone number: 909-590-5600
Copy
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