Individual
DR. LUPITA FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D,
Contact information
Practice address
1711 E DIVISION ST, MOUNT VERNON, WA 98274-4501
(360) 424-7089
Mailing address
1711 E DIVISION ST, MOUNT VERNON, WA 98274-4501
(360) 424-7089
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00007379
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1854
DENTAL LICENCE
PR
01
—
DE00007379
GENERAL DENTIST
WA
Enumeration date
08/08/2006
Last updated
02/07/2023
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