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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