Individual
AUDREY FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2344 MASSACHUSETTS AVE, CAMBRIDGE, MA 02140-1852
(617) 623-2223
Mailing address
62 ORANGE ST APT 1, CHELSEA, MA 02150-1997
(678) 736-3020
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN015306
GA
1223G0001X
General Practice Dentistry
Primary
DN1859262
MA
Other
Enumeration date
10/19/2016
Last updated
03/01/2023
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