Individual
DR. ANGELA NATALI SURYAKUSUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
10833 LE CONTE AVE # CHS20137, LOS ANGELES, CA 90095-3075
(512) 492-2237
Mailing address
2324 YAUPON RANGE DR, LEANDER, TX 78641-4995
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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