Provider Demographics
NPI:1447443031
Name:BADO, JUAN F (DMD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:F
Last Name:BADO
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:PO BOX 1357
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1357
Mailing Address - Country:US
Mailing Address - Phone:787-832-1240
Mailing Address - Fax:787-833-3612
Practice Address - Street 1:111 CALLE DE DIEGO E
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4863
Practice Address - Country:US
Practice Address - Phone:787-832-1240
Practice Address - Fax:787-833-3612
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice