Individual
DR. CHARMANE PONGHIRUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
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
34405
CA
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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