| Harsono Dental Corp | |
|
431 Monterey Ave Ste 6 Los Gatos CA 95030-5319 | |
| (408) 354-1717 | |
| Not Available |
| Full Name | Harsono Dental Corp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 431 Monterey Ave Ste 6, Los Gatos, California |
| Authorized Official Name and Position | Masly Harsono (OWNER) |
| Authorized Official Contact | 6463387593 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harsono Dental Corp 550 Moreland Way 4512 Santa Clara CA 95054-4123 Ph: (650) 667-1369 | Harsono Dental Corp 431 Monterey Ave Ste 6 Los Gatos CA 95030-5319 Ph: (408) 354-1717 |
| NPI Number | 1225588254 |
|---|---|
| Provider Enumeration Date | 10/14/2016 |
| Last Update Date | 05/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225588254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 64977 (California) | Primary |
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