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1821249913
MONTRY S. SUPRONO
LOMA LINDA, CA
NPI
1821249913
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223P0700X Dentist, Prosthodontics
(Licence: CA 56324)
Enumeration Date
2008-10-07
Last Update Date
2008-10-07
Business Address
-- MONTRY S. SUPRONO DDS
11092 ANDERSON STREET LLU SCHOOL OF DENTISTRY
LOMA LINDA, CA 92350-0001
Phone number: 909-558-4613
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Mailing Address
-- MONTRY S. SUPRONO DDS
11092 ANDERSON STREET LLU SCHOOL OF DENTISTRY
LOMA LINDA, CA 92350-0001
Phone number: 909-558-4613
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