Organization
ADRIAN D. FENDERSON, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADRIAN DARVIN FENDERSON DDS (PRESIDENT)
(707) 258-8700
Entity
Organization
Contact information
Practice address
3416 VALLE VERDE DR, NAPA, CA 94558-2415
(707) 258-8700
(707) 255-4542
Mailing address
3416 VALLE VERDE DR, NAPA, CA 94558-2415
(707) 258-8700
(707) 255-4542
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
20852
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306854377
NPI
CA
01
—
20852
CDA LICENSE
CA
Enumeration date
06/04/2007
Last updated
08/22/2020
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