| Ibrahim Irawan Dds | |
|
505 E Arrow Hwy Glendora CA 91740-6034 | |
| (626) 335-2899 | |
| Not Available |
| Full Name | Ibrahim Irawan Dds |
|---|---|
| Speciality | Dentist |
| Location | 505 E Arrow Hwy, Glendora, California |
| Authorized Official Name and Position | Ibrahim Irawan (OWNER) |
| Authorized Official Contact | 6263352899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ibrahim Irawan Dds 505 E Arrow Hwy Glendora CA 91740-6034 Ph: (626) 335-2899 | Ibrahim Irawan Dds 505 E Arrow Hwy Glendora CA 91740-6034 Ph: (626) 335-2899 |
| NPI Number | 1093055980 |
|---|---|
| Provider Enumeration Date | 02/28/2013 |
| Last Update Date | 12/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093055980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 37119 (California) | Primary |
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