Individual
DR. AGOSTO WIHARTOGUNO OEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
214 E CALIFORNIA AVE, RIDGECREST, CA 93555-4103
(760) 375-8416
(760) 375-9071
Mailing address
214 E CALIFORNIA AVE, RIDGECREST, CA 93555-4103
(760) 375-8416
(760) 375-9071
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
39318
CA
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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