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General NPI Number Information
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NPI Number | 1902657810
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Entity Type | Organization
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Legal Business Name | APEX DENTAL GROUP OF DR KRISTINA FERNANDEZ
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 79800 HIGHWAY 111 STE 109
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City | LA QUINTA
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State | CA
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Zip | 92253-6003
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Country | US
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Telephone | 760-775-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 13390 LARKHAVEN DR
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City | MORENO VALLEY
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State | CA
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Zip | 92553-3205
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Country | US
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Telephone | 951-529-9762
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KRISTINA FERNANDEZ
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Credential |
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Telephone | 909-915-5292
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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 |
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License Number State |
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