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Kusumo Sumardi, DDS
General Practice Dentistry in La Verne, California
NPI 1811037435

Kusumo Sumardi is a General Practice Dentistry based in Claremont, CA and is specialized in General Practice. Kusumo Sumardi practices in La Verne, CA and has the professional credentials of DDS. The NPI Number for Kusumo Sumardi is 1811037435 and holds a License No. 41680 (California).

The current practice location address for Kusumo Sumardi is 1965 Foothill Blvd, La Verne, CA and can be reached out via phone at 909-596-6500 and via fax at 909-596-8809.

Location: 1965 Foothill Blvd, La Verne, CA, 91711-1454
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811037435
Provider Name
Kusumo Sumardi
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
1965 Foothill Blvd, La Verne, CA, 91711-1454
Phone Number
909-596-6500
Fax Number
909-596-8809
Provider Enumeration Date
02/06/2007
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1965 Foothill Blvd
City
La Verne
State
California
Zip
91750-3502
Phone Number
909-596-6500
Fax Number
909-596-8809
person
Provider Business Mailing Address Details
Address
1965 Foothill Blvd
City
La Verne
State
California
Zip
91750-3502
Phone Number
909-596-6500
Fax Number
909-596-8809
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
41680 (California)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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