Organization
FERNANDO GUTIERREZ DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HILDA POVEDA (OFFICE MANAGER)
(305) 778-1288
Entity
Organization
Contact information
Practice address
9964 PINES BLVD, PEMBROKE PINES, FL 33024-6139
(954) 432-6222
(954) 432-3815
Mailing address
9964 PINES BLVD, PEMBROKE PINES, FL 33024-6139
(954) 432-6222
(954) 432-3815
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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