Individual
SHELLY VANESSA HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
964 AJAX STREET, JACKSONVILLE, FL 32214-0001
(904) 546-7000
Mailing address
964 AJAX STREET, JACKSONVILLE, FL 32214-0001
(904) 546-7000
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
18337
FL
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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