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Individual

ANA BUENDIA WANNARKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
925 W 34TH ST, DEN 4230 M/C 0641, LOS ANGELES, CA 90089-0641
(213) 740-8663
Mailing address
925 W 34TH ST, DEN 4230 M/C 0641, LOS ANGELES, CA 90089-0641
(213) 740-8663

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60194063
WA

Other

Enumeration date
01/04/2012
Last updated
01/04/2012
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