Andrew Adiputra

NPI #1205489671 in Champaign, Illinois

Provider Information

NPI Number
1205489671
Entity Type
Individual
Name
Andrew Adiputra
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dentist
Enumeration Date
Jul 24, 2019
Last Updated
Jul 24, 2019

Practice Location

Address
314 W KIRBY AVE
ZIP Code
61820-7208
Phone
(217) 398-9898

Specialties & Taxonomy Codes

Specialty
Dentist

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