Park Avenue Family Dentistry
NPI #1205019858 in Pomona, California
Provider Information
- NPI Number
- 1205019858
- Entity Type
- Organization
- Organization Name
- Park Avenue Family Dentistry
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Dec 6, 2007
- Last Updated
- Dec 6, 2007
Practice Location
- Address
- 1087 N PARK AVE
- City
- Pomona
- State
- California
- ZIP Code
- 91768-3026
- Phone
- (909) 629-0201
Authorized Official
- Name
- MR. SOEDHARSONO JUDO, D.D.S.
- Title
- OWNER
- Phone
- (909) 629-0201
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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