Andre Widodo DDS a Professional Corporation
Andre Widodo DDS a Professional Corporation is a Dental Clinic/Center in El Monte, California. Licensed in California. Registered with an NPI since 2009.
- Licensed in
- CA
- In the registry since
- 2009
Practice location Address checks out
11635 Valley Blvd Ste EEl Monte, CA 91732-3071
Phone: (626) 444-7645
Fax: (626) 444-7628
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dental Clinic/Center (primary) | Taxonomy 261QD0000X · Licence 46152 (CA) |
|---|
Record details
| NPI number | 1447583661 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Andre Widodo — Dentist / Owner · (626) 444-7645 |
| NPI enumerated | September 8, 2009 |
| Last updated in NPPES | September 8, 2009 |
| Mailing address | 11635 Valley Blvd Ste E, El Monte, CA 91732-3071 |
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