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Montry S. Suprono, DDS
Prosthodontist in Loma Linda, California
NPI 1821249913

Montry S. Suprono is a Prosthodontist based in Loma Linda, CA and is specialized in Prosthodontics. Montry S. Suprono practices in Loma Linda, CA and has the professional credentials of DDS. The NPI Number for Montry S. Suprono is 1821249913 and holds a License No. 56324 (California).

The current practice location address for Montry S. Suprono is 11092 Anderson Street, Loma Linda, CA and can be reached out via phone at 909-558-4613 and via fax at 909-558-4192.

Location: 11092 Anderson Street, Loma Linda, CA, 92350-0001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821249913
Provider Name
Montry S. Suprono
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
11092 Anderson Street, Loma Linda, CA, 92350-0001
Phone Number
909-558-4613
Fax Number
909-558-4192
Provider Enumeration Date
10/07/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
56324 01 CA STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
11092 Anderson Street
City
Loma Linda
State
California
Zip
92350-0001
Phone Number
909-558-4613
Fax Number
909-558-4192
person
Provider Business Mailing Address Details
Address
11092 Anderson Street
City
Loma Linda
State
California
Zip
92350-0001
Phone Number
909-558-4613
Fax Number
909-558-4192
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Prosthodontics
Taxonomy
1223P0700X
License No.
56324 (California)
Definition
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
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