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1023239944
MAVERN SUPRONO
COLTON, CA
NPI
1023239944
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: CA 27842)
Enumeration Date
2007-05-01
Last Update Date
2007-07-08
Business Address
Mr. MAVERN SUPRONO DDS
1080 E WASHINGTON B
COLTON, CA 92324
Phone number: 909-783-9099
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Mailing Address
Mr. MAVERN SUPRONO DDS
PO BOX 903
LOMA LINDA, CA 92354
Phone number: 909-783-9099
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