DR. Martin Winata Laksana, D.D.S.
NPI #1295894061 in Upland, California
Provider Information
- NPI Number
- 1295894061
- Entity Type
- Individual
- Name
- DR. Martin Winata Laksana, D.D.S.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- D.D.S.
- Enumeration Date
- Dec 7, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 130 S MOUNTAIN AVE
- Address 2
- #G
- City
- Upland
- State
- California
- ZIP Code
- 91786-6268
- Phone
- (909) 949-7002
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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