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General NPI Number Information
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NPI Number | 1811171077
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Entity Type | Organization
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Legal Business Name | DINO C. HERNANDEZ,D.D.S, INC.
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 1014 W BEVERLY BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4139
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Country | US
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Telephone | 323-725-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 1014 W BEVERLY BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4139
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. DINO C. HERNANDEZ
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Credential |
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Telephone | 323-725-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 49332
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License Number State | CA
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