Sumardi, Kusumo
Sumardi, Kusumo is an sole proprietor health care provider with primary practice located at 1965 Foothill Blvd Suite L, La Verne CA 91750-3502. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Sumardi, Kusumo can be contacted via phone (909) 596-6500.Contact Information
Primary practice address
1965 Foothill Blvd Suite L
La Verne CA 91750-3502
Phone: (909) 596-6500
Fax: (909) 596-8809
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 41680 | California |
Profile Details
| NPI number | 1811037435 |
|---|---|
| LBN Legal business name | Sumardi, Kusumo |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 6th, 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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