Individual
DR. RAHADIAN KRIS PUTRASAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3195 W RAY RD, SUITE #3, CHANDLER, AZ 85226-2417
(480) 788-3627
Mailing address
7650 S MCCLINTOCK DR, SUITE 103-235, TEMPE, AZ 85284-1672
(480) 788-3627
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4695
AZ
Other
Enumeration date
10/05/2006
Last updated
07/20/2011
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