Provider Demographics
NPI:1295869261
Name:JOGLAR, FERNANDO LUIS (DMD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:LUIS
Last Name:JOGLAR
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 1:1521 CALLE CAVALIERI
Mailing Address - Street 2:URBANIZACION BELISA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6122
Mailing Address - Country:US
Mailing Address - Phone:787-767-7249
Mailing Address - Fax:
Practice Address - Street 1:D15 CALLE AA
Practice Address - Street 2:CIUDAD UNIVERSITARIA
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-3151
Practice Address - Country:US
Practice Address - Phone:787-761-9560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0723122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist