Provider Demographics
NPI:1619074598
Name:JUAN E SAVELLI DMD MSD PA
Entity Type:Organization
Organization Name:JUAN E SAVELLI DMD MSD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAVELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:772-223-4646
Mailing Address - Street 1:900 SE OCEAN BLVD
Mailing Address - Street 2:STE 216B
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994
Mailing Address - Country:US
Mailing Address - Phone:772-223-4646
Mailing Address - Fax:772-223-4545
Practice Address - Street 1:900 SE OCEAN BLVD
Practice Address - Street 2:STE 216B
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN164411223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty