Individual
JONATHAN ALEXANDER FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1000 PINE TOP RD, BELTON, SC 29627-9539
(864) 338-6589
Mailing address
1121 OLD MILL RD, EASLEY, SC 29642-9501
(864) 991-7302
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DGD.10207
SC
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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