| Jun A. Soetanto Dmd Llc | |
|
2266 Kresge Dr Amherst OH 44001-1260 | |
| (440) 960-0090 | |
| Not Available |
| Full Name | Jun A. Soetanto Dmd Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2266 Kresge Dr, Amherst, Ohio |
| Authorized Official Name and Position | Jun Soetanto (OWNER) |
| Authorized Official Contact | 4845574808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jun A. Soetanto Dmd Llc 2266 Kresge Dr Amherst OH 44001-1260 Ph: (440) 960-0090 | Jun A. Soetanto Dmd Llc 2266 Kresge Dr Amherst OH 44001-1260 Ph: (440) 960-0090 |
| NPI Number | 1942955216 |
|---|---|
| Provider Enumeration Date | 02/15/2022 |
| Last Update Date | 02/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942955216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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