Provider Demographics
NPI:1851311500
Name:FERNANDO, MARIA VICTORIA GUANIO (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIA VICTORIA
Middle Name:GUANIO
Last Name:FERNANDO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7342 GREENHILL RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2219
Mailing Address - Country:US
Mailing Address - Phone:215-473-7879
Mailing Address - Fax:215-877-7751
Practice Address - Street 1:7342 GREENHILL RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2219
Practice Address - Country:US
Practice Address - Phone:215-473-7879
Practice Address - Fax:215-877-7751
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029787L122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist