| Charmane Ponghirun, Dds. Inc. | |
|
1237 N Grand Ave Walnut CA 91789-1343 | |
| (909) 594-7027 | |
| (909) 594-7027 |
| Full Name | Charmane Ponghirun, Dds. Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1237 N Grand Ave, Walnut, California |
| Authorized Official Name and Position | Charmane Ponghirun (PRESIDENT) |
| Authorized Official Contact | 9095947027 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charmane Ponghirun, Dds. Inc. 1237 N Grand Ave Walnut CA 91789-1343 Ph: (909) 594-7027 | Charmane Ponghirun, Dds. Inc. 1237 N Grand Ave Walnut CA 91789-1343 Ph: (909) 594-7027 |
| NPI Number | 1699912857 |
|---|---|
| Provider Enumeration Date | 01/09/2009 |
| Last Update Date | 01/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699912857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | B34405 (California) | Primary |
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