Heru Wiredja,dds,inc

NPI #1659783918 in Maywood, California

Provider Information

NPI Number: 1659783918
Entity Type: Organization
Organization Name: Heru Wiredja,dds,inc
Primary Specialty: Dentist
Enumeration Date: May 21, 2014
Last Updated: May 21, 2014

Practice Location

Address: 6100 ATLANTIC BLVD
Address 2: SUITE I
City: Maywood
State: California
ZIP Code: 90270-3131
Phone: (323) 771-7551

Authorized Official

Name: HERU WIREDJA, DDS
Title: PRESIDENT
Phone: (323) 771-7551

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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