Park Avenue Family Dentistry
Park Avenue Family Dentistry provides General Practice Dentistry in Pomona, California. Licensed in California. Registered with an NPI since 2007.
- Licensed in
- CA
- In the registry since
- 2007
Practice location Address checks out
1087 N Park AvePomona, CA 91768-3026 Not confirmed with CMS for 18 years — call before visiting
Phone: (909) 629-0201
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence 34127 (CA) |
|---|
Record details
| NPI number | 1205019858 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Soedharsono Judo — Owner · (909) 629-0201 |
| Other names | Park Avenue Family Dentistry |
| NPI enumerated | December 6, 2007 |
| Last updated in NPPES | December 6, 2007 |
| Mailing address | 1087 N Park Ave, Pomona, CA 91768-3026 |
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