Provider Demographics
NPI:1447323902
Name:BERNSTINE, BYRON DALE (DDS)
Entity type:Individual
Prefix:MR
First Name:BYRON
Middle Name:DALE
Last Name:BERNSTINE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1887 N UKIAH WAY
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5076
Mailing Address - Country:US
Mailing Address - Phone:909-920-9971
Mailing Address - Fax:
Practice Address - Street 1:615 N BENSON
Practice Address - Street 2:STE F
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5076
Practice Address - Country:US
Practice Address - Phone:909-949-1389
Practice Address - Fax:909-949-1373
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice