Individual
DR. AGUNG PRIBADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
600 E WHITTIER BLVD, LA HABRA, CA 90631-3929
(562) 691-3070
(562) 691-7198
Mailing address
600 E WHITTIER BLVD, LA HABRA, CA 90631-3929
(562) 691-3070
(562) 691-7198
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
45519
CA
Other
Enumeration date
02/11/2009
Last updated
02/11/2009
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