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Organization
WIDODO & ONG DDS, INC.
Active
Organization
WIDODO & ONG DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDRE WIDODO DDS (DENTIST)
(626) 444-7645
Entity
Organization
Contact information
Practice address
11635 VALLEY BLVD STE E, EL MONTE, CA 91732-3071
(626) 444-7645
(626) 444-7628
Mailing address
11635 VALLEY BLVD STE E, EL MONTE, CA 91732-3071
(626) 444-7645
(626) 444-7628
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
46152
CA
Other
Enumeration date
02/28/2013
Last updated
02/28/2013
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