Sudibjo, Thomas

Sudibjo, Thomas is an individual health care provider with primary practice located at 1096 Irvine Blvd , Tustin CA 92780-3527. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Sudibjo, Thomas can be contacted via phone (714) 838-6777.

Contact Information

Primary practice address
1096 Irvine Blvd Tustin CA 92780-3527
Phone: (714) 838-6777
Fax: (714) 838-8277
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 45983 California

Profile Details

NPI number 1891834099
LBN Legal business name Sudibjo, Thomas
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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