KUSUMO SUMARDI

LA VERNE, CA
NPI1811037435
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: CA  41680)
Enumeration Date2007-02-06
Last Update Date2007-07-08
Business Address
-- KUSUMO SUMARDI D.D.S.
1965 FOOTHILL BLVD SUITE L
LA VERNE, CA 91750-3502
Phone number: 909-596-6500
Mailing Address
-- KUSUMO SUMARDI D.D.S.
3870 GRAND AVE
CLAREMONT, CA 91711-1454
Phone number: 909-621-9088