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NPI

654

Facility Name

indowartasumber

First Name

indo

Last Name

wartasumber

Physical Street Address -- NOTE:  Please return to complete this Survey separately for each physical service location where you provide dental services.

https://indowarta.com/

Physical City

CALIFORNIA

Physical State (Please use state abbreviation ex: ME for Maine)

CALIFORNIA

Physical Zip Code

90,011

Are you currently accepting new MaineCare members?

Yes

Are you able to accommodate children with special needs?

No

Are you able to serve children with mobility issues such as wheelchair ramps and wider doorways?

Yes

Are you able to provide services to children with complex health needs such as sedation?

No

Are you able to provide services to children with intellectual disabilities such as autism?

No

Dental License Number

5375353
Created at 2/21/2022 1:51 AM by ***
Last modified at 2/21/2022 1:51 AM by ***