Mavern Suprono DDS INC

NPI #1477622165 in Colton, California

Provider Information

NPI Number: 1477622165
Entity Type: Organization
Organization Name: Mavern Suprono DDS INC
Primary Specialty: Dentist
Enumeration Date: Nov 7, 2006
Last Updated: Aug 22, 2020

Practice Location

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

Authorized Official

Name: MAVERN S SUPRONO, DDS
Title: PRESIDENT
Phone: (909) 783-9099

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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