Individual provider · Type 1 NPI
Traci Rachelle Fernandes, DDS, MS
Orthodontics and Dentofacial Orthopedics Dentistry · Pismo Beach, CA
Practice location
901 Oak Park Blvd Ste 203
Pismo Beach, CA 93449-3410
Fax (805) 489-8234
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry Primary | 1223X0400X | 41830 (CA) |
Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…
About NPI 1619610847
Traci Rachelle Fernandes, DDS, MS's National Provider Identifier is 1619610847, issued on Apr 15, 2022. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Pismo Beach, CA. The record was last updated on Apr 15, 2022.