Organization
FERNANDES ORTHODONTICS
Active
Parent organization
FERNANDES ORTHODONTICS
Organization subpart
Yes
Provider details
NPI number
Legal business name
FERNANDES ORTHODONTICS
Authorized official
AVID SEGURA (DENTAL ASSISTANT)
(310) 670-1411
Entity
Organization
Contact information
Practice address
8540 S SEPULVEDA BLVD STE 1012, LOS ANGELES, CA 90045-3819
(310) 670-1411
(310) 670-1968
Mailing address
8540 S SEPULVEDA BLVD STE 1012, LOS ANGELES, CA 90045-3819
(310) 670-1411
(310) 670-1968
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
10/18/2024
Last updated
11/13/2024
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