All Medicaid billing entities listing SUSANTO, HANNY (PRESIDENT) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| California | 1 | $45K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | SUSANTO DENTAL CORPORATION | LA PUENTE, CA | Dentist | $45K |