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Organization

RENATA CARVALHO DA FONSECA DDS., A DENTAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RENATA CARVALHO DA FONSECA DDS (PRESIDENT)
(310) 463-3294
Entity
Organization

Contact information

Practice address
23101 SHERMAN PL STE 201, WEST HILLS, CA 91307-2019
(818) 716-8424
Mailing address
578 WASHINGTON BLVD UNIT 523, MARINA DEL REY, CA 90292-5421
(310) 463-3294

Taxonomy

Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
1223G0001X
General Practice Dentistry
1223P0221X
Pediatric Dentistry
Primary
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry

Other

Enumeration date
11/12/2019
Last updated
11/12/2019
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