Organization
AGUNG PRIBADI DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AGUNG PRIBADI DDS (CEO)
(562) 691-3070
Entity
Organization
Contact information
Practice address
600 E WHITTIER BLVD, LA HABRA, CA 90631
(562) 691-3070
(562) 691-7198
Mailing address
600 E WHITTIER BLVD, LA HABRA, CA 90631
(562) 691-3070
(562) 691-7198
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
45519
CA
Other
Enumeration date
09/13/2006
Last updated
05/22/2013
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