Individual
DR. STEPHANIE P PURNOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
20514 SARATOGA LOS GATOS RD STE A, SARATOGA, CA 95070-5970
(408) 872-1900
Mailing address
7766 HUNTRIDGE LN, CUPERTINO, CA 95014-4206
(626) 715-7238
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
63704
CA
Other
Enumeration date
08/09/2017
Last updated
08/09/2017
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