Organization
ECHARTE,FERNANDEZ PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMAR JESUS FERNANDEZ DDS (VICE-PRESIDENT)
(213) 483-1234
Entity
Organization
Contact information
Practice address
525 S ALVARADO ST, LOS ANGELES, CA 90057-2903
(213) 483-1234
Mailing address
525 S ALVARADO ST, LOS ANGELES, CA 90057-2903
(213) 483-1234
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53449
CA
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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