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Organization
Y.A.SATYARAHARDJA DDS.INC.
Active
Organization
Y.A.SATYARAHARDJA DDS.INC.
Active
Other names
Citrus Grove Dental
Organization subpart
No
Provider details
NPI number
Authorized official
YINTAWATI SATYARAHARDJA DDS (PRESIDENT)
(626) 966-0300
Entity
Organization
Contact information
Practice address
2520 E WORKMAN AVE, WEST COVINA, CA 91791-1534
(626) 966-0300
(696) 966-0336
Mailing address
2520 E WORKMAN AVE, WEST COVINA, CA 91791-1534
(626) 966-0300
(696) 966-0336
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
46955
CA
Other
Enumeration date
11/13/2013
Last updated
11/13/2013
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