MR. Mavern Suprono, DDS

NPI #1023239944 in Colton, California

Provider Information

NPI Number: 1023239944
Entity Type: Individual
Name: MR. Mavern Suprono, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: May 1, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1080 E WASHINGTON
Address 2: B
City: Colton
State: California
ZIP Code: 92324
Phone: (909) 783-9099

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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