Individual
DR. STACIE DAWN FENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS MS
Contact information
Practice address
8689 FOLSOM BLVD, SACRAMENTO, CA 95826
(916) 381-7171
(916) 381-1171
Mailing address
350 MEADOW GATE RD, MEADOW VISTA, CA 95722
(916) 381-7171
(530) 878-1470
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
52724
CA
Other
Enumeration date
10/17/2007
Last updated
10/17/2007
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