Stacie Dawn Fenderson DDS MS

NPI 1053500959 - Dentist - 1223X0400X

NPI Details
NPI 1053500959
Gender Female
Enumeration Date 10/17/2007
Last Updated 10/17/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
8689 FOLSOM BLVD
SACRAMENTO CA, 95826, US
Phone (916) 381-7171
Fax (916) 381-1171
Business Location
350 MEADOW GATE RD
MEADOW VISTA CA, 95722, US
Phone (916) 381-7171
Fax (530) 878-1470
Toxanomy
Taxonomy Code 1223X0400X
License State California
License Number 52724
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According to our database, Dr. Stacie Dawn Fenderson DDS MS NPI is 1053500959, taxonomy code is 1223X0400X and license number is 52724, license state is located at California. Stacie Dawn Fenderson DDS MS physically located at 8689 Folsom Blvd, Sacramento CA, 95826. NPI Number Stacie Dawn Fenderson DDS MS has the Individual type.

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1053500959 NPI number is provided on an as is basis without warranty of any kind. 1053500959 is maintained by the National Plan & Provider Enumeration System. The contents of Stacie Dawn Fenderson DDS MS are for informational purposes only.