Individual
JON FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
635 ALBANY ST, BOSTON, MA 02118-3550
(617) 358-8300
Mailing address
635 ALBANY ST, BOSTON, MA 02118-3550
(617) 358-8300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN100623
MA
122300000X
Dentist
Primary
DN10000555
MA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/11/2024
Last updated
01/02/2025
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