Individual
DR. JESSICA SUHARDJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, MS
Contact information
Practice address
15290 BEAR VALLEY RD STE B, VICTORVILLE, CA 92395-8515
(760) 493-3215
Mailing address
2167 N 1ST AVE, UPLAND, CA 91784-1446
(909) 331-8445
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DDS108563
CA
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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