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NPI Code Detail

MEDICARE: STEVEN D. HERNANDEZ, D.D.S. A PROFESSIONAL CORPORATION

MEDICARE: STEVEN D. HERNANDEZ, D.D.S. A PROFESSIONAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist37836CA

General Provider Information

NPI Number : 1891902987
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEVEN D. HERNANDEZ, D.D.S. A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 2652 SADDLE RIDGE DR
Second Line :
City : COVINA
State : CA
Zip : 91724-3838
Country : US
Telephone Number : 626-332-4596
Fax Number :
Provider Business Practice Location Address
First Line : 9560 BASELINE RD
Second Line : SUITE B
City : ALTA LOMA
State : CA
Zip : 91701-6435
Country : US
Telephone Number : 909-987-7676
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. STEVEN D. HERNANDEZ
Credential : DDS
Telephone Number : 626-332-4596
Provider Enumeration Date : 05/17/2007
Last Update Date : 10/02/2007

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