| Widodo & Ong Dds, Inc. | |
|
11635 Valley Blvd Ste E El Monte CA 91732-3071 | |
| (626) 444-7645 | |
| (626) 444-7628 |
| Full Name | Widodo & Ong Dds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11635 Valley Blvd Ste E, El Monte, California |
| Authorized Official Name and Position | Andre Widodo (DENTIST) |
| Authorized Official Contact | 6264447645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Widodo & Ong Dds, Inc. 11635 Valley Blvd Ste E El Monte CA 91732-3071 Ph: (626) 444-7645 | Widodo & Ong Dds, Inc. 11635 Valley Blvd Ste E El Monte CA 91732-3071 Ph: (626) 444-7645 |
| NPI Number | 1245570258 |
|---|---|
| Provider Enumeration Date | 02/28/2013 |
| Last Update Date | 02/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245570258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 46152 (California) | Primary |
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