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Organization
VIVIAN FERNANDEZ DDS.INC
Active
Organization
VIVIAN FERNANDEZ DDS.INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN FERNANDEZ (OWNER)
(916) 714-5422
Entity
Organization
Contact information
Practice address
9320 ELK GROVE BLVD STE 170, ELK GROVE, CA 95624-5061
(916) 714-5422
(916) 714-5429
Mailing address
9320 ELK GROVE BLVD STE 170, ELK GROVE, CA 95624-5061
(916) 714-5422
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/28/2018
Last updated
07/09/2019
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