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1629521703
HANSEL POERWANTO
SACRAMENTO, CA
NPI
1629521703
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: CA 100447)
Enumeration Date
2016-07-26
Last Update Date
2023-01-23
Business Address
HANSEL POERWANTO DDS
1860 HOWE AVE STE 440
SACRAMENTO, CA 95825-1098
Phone number: 916-569-8484
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Mailing Address
HANSEL POERWANTO DDS
PO BOX 7194
STOCKTON, CA 95267-0194
Phone number:
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