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General NPI Number Information
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NPI Number | 1972906550
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Entity Type | Individual
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Provider Name | FERNANDO ORESTES SAN JUAN JR. D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2014
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 840 US 1 STE 350
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-3834
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Country | US
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Telephone | 561-694-1740
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 SE HAMPSHIRE WAY APT 201
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City | STUART
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State | FL
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Zip | 34994-5770
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Country | US
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Telephone | 305-308-7335
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN20988
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License Number State | FL
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