Organization
CHARMANE PONGHIRUN, DDS. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARMANE PONGHIRUN DDS (PRESIDENT)
(909) 594-7027
Entity
Organization
Contact information
Practice address
1237 N GRAND AVE, WALNUT, CA 91789-1343
(909) 594-7027
(909) 594-7027
Mailing address
1237 N GRAND AVE, WALNUT, CA 91789-1343
(909) 594-7027
(909) 594-7027
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
B34405
CA
Other
Enumeration date
01/09/2009
Last updated
01/09/2009
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