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Organization
HARTANTO L. JUSTIN D.D.S. , INC
Active
Organization
HARTANTO L. JUSTIN D.D.S. , INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARTANTO LAWRENCE JUSTIN D.D.S (PRESIDENT)
(323) 221-6090
Entity
Organization
Contact information
Practice address
3231 N BROADWAY, LOS ANGELES, CA 90031-2801
(323) 221-6090
Mailing address
3231 N BROADWAY, LOS ANGELES, CA 90031-2801
(323) 221-6090
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
39019
CA
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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