Provider Demographics
NPI:1659487577
Name:ITURRINO, FERNANDO L (DMD)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:L
Last Name:ITURRINO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CALLE DE DIEGO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925-2929
Mailing Address - Country:US
Mailing Address - Phone:787-764-0512
Mailing Address - Fax:787-758-0203
Practice Address - Street 1:8 CALLE DE DIEGO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-2929
Practice Address - Country:US
Practice Address - Phone:787-764-0512
Practice Address - Fax:787-758-0203
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice