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1053754127
JUAN FAJA-FERNANDEZ
MYRTLE BEACH, SC
NPI
1053754127
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223X0400X Dentist Orthodontics and Dentofacial Orthopedics
(Licence: SC 4461)
Enumeration Date
2013-04-09
Last Update Date
2013-04-09
Business Address
JUAN FAJA-FERNANDEZ D.M.D.
107 SURGEONS DRIVE
MYRTLE BEACH, SC 29579
Phone number: 843-206-1116
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Mailing Address
JUAN FAJA-FERNANDEZ D.M.D.
PO BOX 13799
FLORENCE, SC 29504-3799
Phone number:
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