Individual
MARIA FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-6033
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-6039
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
063660-01
NY
Other
Enumeration date
05/03/2022
Last updated
12/20/2024
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