Individual
DR. HIRAN R FERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
165 N. MERAMEC AVE, SUITE 300, CLAYTON, MO 63105-3772
(314) 726-2755
(314) 726-9538
Mailing address
165 N. MERAMEC AVE, SUITE 300, CLAYTON, MO 63105-3772
(314) 726-2755
(314) 726-9538
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
23369
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2011001387
MO
390200000X
Student in an Organized Health Care Education/Training Program
P56783
NY
Other
Enumeration date
05/04/2007
Last updated
04/11/2023
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