Provider Demographics
NPI:1467502146
Name:GIUSTI, JUAN BAUTISTA (DMD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:BAUTISTA
Last Name:GIUSTI
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 1:60 AVE WINSTON CHURCHILL
Mailing Address - Street 2:1602 VILLAS DEL SENORIAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6704
Mailing Address - Country:US
Mailing Address - Phone:787-760-4393
Mailing Address - Fax:
Practice Address - Street 1:1692 CALLE PARANA
Practice Address - Street 2:EL CEREZAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-3144
Practice Address - Country:US
Practice Address - Phone:787-763-4837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR917122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR40851OtherTRIPLE S, INC