Adiputra, Andrew

Adiputra, Andrew is an individual health care provider with primary practice located at 314 W Kirby Ave , Champaign IL 61820-7208. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Adiputra, Andrew can be contacted via phone (217) 398-9898.

Contact Information

Primary practice address
314 W Kirby Ave Champaign IL 61820-7208
Phone: (217) 398-9898
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019032270 Illinois

Profile Details

NPI number 1205489671
LBN Legal business name Adiputra, Andrew
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2019
Last updated Jul 24th, 2019 - about 7 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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