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General NPI Number Information
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NPI Number | 1891558797
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Entity Type | Organization
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Legal Business Name | KYLENE H FERNANDEZ DDS MS LLC
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Dates
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Enumeration Date | 02/02/2024
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 3663 RIDGE MILL DR STE 102
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City | HILLIARD
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State | OH
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Zip | 43026-7799
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Country | US
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Telephone | 614-527-1000
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Fax | 614-527-0100
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Provider Business Mailing Address
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Address Line | 3663 RIDGE MILL DR STE 102
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City | HILLIARD
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State | OH
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Zip | 43026-7799
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Country | US
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Telephone | 614-527-1000
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Fax | 614-527-0100
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Authorized Official
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Title or Position | DENTIST
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Name | DR. KYLENE H FERNANDEZ
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Credential | DDS MS
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Telephone | 614-527-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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