Individual
ANGELICA FERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
402 S LEWIS LN, CARBONDALE, IL 62901-3547
(618) 519-9200
Mailing address
109 CALIFORNIA ST, PO BOX 577, CARTERVILLE, IL 62918
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.037323
IL
Other
Enumeration date
07/16/2026
Last updated
07/16/2026
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