Provider Demographics
NPI:1710697255
Name:ALEJANDRO FUENTES
Entity Type:Organization
Organization Name:ALEJANDRO FUENTES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-272-9021
Mailing Address - Street 1:84640 ROMERO ST
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-1367
Mailing Address - Country:US
Mailing Address - Phone:686-189-3940
Mailing Address - Fax:619-329-9663
Practice Address - Street 1:CALZ. DE LAS AMERICAS
Practice Address - Street 2:62 CUAUHTEMOC SUR
Practice Address - City:MEXICALI
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:21200
Practice Address - Country:MX
Practice Address - Phone:619-270-9021
Practice Address - Fax:619-329-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty