Individual
DR. FERNANDO VELASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
913 NW GARDEN VALLEY BLVD, DENTAL CLINIC, ROSEBURG, OR 97471-6523
(541) 440-1242
Mailing address
913 NW GARDEN VALLEY BLVD, DENTAL CLINIC, ROSEBURG, OR 97471-6523
(541) 440-1242
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61693
CA
122300000X
Dentist
DN1856067
MA
Other
Enumeration date
01/18/2014
Last updated
02/09/2015
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