Provider Demographics
NPI:1801993076
Name:HECTOR M. FERNANDEZ, D.D.S., INC.
Entity type:Organization
Organization Name:HECTOR M. FERNANDEZ, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-852-7660
Mailing Address - Street 1:11230 GOLD EXPRESS DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670-4484
Mailing Address - Country:US
Mailing Address - Phone:916-852-7660
Mailing Address - Fax:
Practice Address - Street 1:11230 GOLD EXPRESS DR
Practice Address - Street 2:SUITE 306
Practice Address - City:GOLD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95670-4484
Practice Address - Country:US
Practice Address - Phone:916-852-7660
Practice Address - Fax:916-852-7694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA385201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty