Organization
SEABREEZE ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN FAJA FERNANDEZ DMD (ORTHODONTIST/BUSINESS OWNER)
(843) 903-3300
Entity
Organization
Contact information
Practice address
107 SURGEONS DR, MYRTLE BEACH, SC 29579-5198
(843) 903-3300
Mailing address
107 SURGEONS DR, MYRTLE BEACH, SC 29579-5198
(843) 903-3300
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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