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Organization
E.WENDY HERNANDEZ, DDS, INC
Active
Organization
E.WENDY HERNANDEZ, DDS, INC
Active
Other names
Heavenly Kids Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELSA WENDY HERNANDEZ DDS (OWNER/PRESIDENT)
(619) 251-1312
Entity
Organization
Contact information
Practice address
1210 N LONG BEACH BLVD STE 196, COMPTON, CA 90221-1685
(424) 785-8708
(424) 785-8718
Mailing address
12920 RUNWAY RD UNIT 310, PLAYA VISTA, CA 90094-2313
(424) 785-8708
(424) 785-8718
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
56388
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437580644
ELSA W HERNANDEZ, DDS, INC
CA
01
—
1497938401
DENTIST
CA
Enumeration date
08/24/2016
Last updated
08/24/2016
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