Provider Demographics
NPI:1609769330
Name:LORES SEIJAS, FERNANDO JOSE (DMD)
Entity type:Individual
Prefix:
First Name:FERNANDO
Middle Name:JOSE
Last Name:LORES SEIJAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:FERNANDO
Other - Middle Name:JOSE
Other - Last Name:LORES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:450 N 18TH ST APT 307
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-4088
Mailing Address - Country:US
Mailing Address - Phone:609-786-0121
Mailing Address - Fax:
Practice Address - Street 1:202 ROUTE 130 N
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077
Practice Address - Country:US
Practice Address - Phone:856-303-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI03092700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist