Eric Fennema, O.D

NPI 1710048939 · on the registry since 2006 · sole proprietor

Practice

Address: 29950 Haun Rd
Suite 206
Sun City, CA 92586
Phone: (951) 679-0545
Fax: (951) 679-6154
Organisation at this address: Ghazal Dental Corporation
Carolyn Ghazal, D.D.S., Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 152W00000X
152W00000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2011-09-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California