Individual
DR. JAIME JOSE FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
458 OLD COUNTRY RD, MELVILLE, NY 11747-1825
(631) 423-6767
Mailing address
11 TERRACE PL, HICKSVILLE, NY 11801-4335
(516) 827-1989
(516) 827-1989
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
045094
NY
Other
Enumeration date
02/14/2007
Last updated
07/08/2007
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