Organization · Type 2 NPI
Andre Widodo DDS A Professional Corporation
Dental Clinic/Center · El Monte, CA
NPI number
1447583661
Active
Practice location
11635 Valley Blvd Ste E
El Monte, CA 91732-3071
Fax (626) 444-7628
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | 46152 (CA) |
Dental Clinic/Center: Definition to come...
Another provider at this address
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About NPI 1447583661
Andre Widodo DDS A Professional Corporation's National Provider Identifier is 1447583661, issued on Sep 8, 2009. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in El Monte, CA. The record was last updated on Sep 8, 2009.