# ECHARTE, FERNANDEZ PROFESSIONAL DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669870341
- **Authorized official:** DR. GONAZALO ECHARTE DDS (PRESIDENT)
- **Authorized official phone:** (626) 350-7087

## Contact information

- **Practice address:** 1150 N HACIENDA BLVD, LA PUENTE, CA 91744-2023
- **Practice address phone:** (626) 350-7088
- **Practice address fax:** (626) 350-8850
- **Mailing address:** 1150 N HACIENDA BLVD, LA PUENTE, CA 91744-2023
- **Mailing address phone:** (626) 350-7088
- **Mailing address fax:** (626) 350-8850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 52379 | CA | Yes |

## Other

- **Enumeration date:** 12/12/2014
- **Last updated:** 12/12/2014