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Santoso Tirtawidjaja, DDS
NPI 1295896850 · on the registry since 2006 · sole proprietor
Practice
- Address
- 1200 West Martin Luther King Blvd
Los Angeles, CA 90037 - Phone
- (323) 295-8306
Registry record
- Primary taxonomy
- Dentist
122300000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California