| P Putrasahan Dds Inc | |
|
68905 Vista Chino Cathedral City CA 92234-4866 | |
| (760) 325-2503 | |
| Not Available |
| Full Name | P Putrasahan Dds Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 68905 Vista Chino, Cathedral City, California |
| Authorized Official Name and Position | Perri Sofian Putrasahan (OWNER) |
| Authorized Official Contact | 7603252503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| P Putrasahan Dds Inc 68905 Vista Chino Cathedral City CA 92234-4866 Ph: (760) 325-2503 | P Putrasahan Dds Inc 68905 Vista Chino Cathedral City CA 92234-4866 Ph: (760) 325-2503 |
| NPI Number | 1831386168 |
|---|---|
| Provider Enumeration Date | 10/01/2007 |
| Last Update Date | 12/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831386168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 39466 (California) | Primary |
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