SULAEMAN PROFESSIONAL DENTAL INC. NPI 1063537538

NPI Information

SULAEMAN PROFESSIONAL DENTAL, INC. is a general practice dentist in San Bernardino, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. SULAEMAN PROFESSIONAL DENTAL, INC. NPI is 1063537538. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Wijaya Sulaeman, D.d.s..

The provider's business location address is:

25054 BASE LINE ST
SAN BERNARDINO, CA
ZIP 92410-026
Phone: (909) 889-9591
Fax: (909) 889-8721

The provider's authorized official is Audrey Indhira Sulaeman .
The authorized official title is Dentist and has the following contact phone number (909) 889-9591.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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