Provider Demographics
NPI:1093054405
Name:SAVELLI, JUAN E (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:E
Last Name:SAVELLI
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 SE OCEAN BLVD STE 216B
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3509
Mailing Address - Country:US
Mailing Address - Phone:772-223-4646
Mailing Address - Fax:772-223-4545
Practice Address - Street 1:900 SE OCEAN BLVD. STE. 216B
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994
Practice Address - Country:US
Practice Address - Phone:772-223-4646
Practice Address - Fax:772-223-4545
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN164411223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics