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1053500959
STACIE DAWN FENDERSON
SACRAMENTO, CA
NPI
1053500959
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: CA 52724)
Enumeration Date
2007-10-17
Last Update Date
2007-10-17
Business Address
Dr. STACIE DAWN FENDERSON DDS MS
8689 FOLSOM BLVD
SACRAMENTO, CA 95826
Phone number: 916-381-7171
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Mailing Address
Dr. STACIE DAWN FENDERSON DDS MS
350 MEADOW GATE RD
MEADOW VISTA, CA 95722
Phone number: 916-381-7171
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