Francisco P. San Nicolas Jr., DMD
Individual provider Active NPI Pediatric Dentistry · Hagatra, GU
NPI 1457582991 · NPPES record last updated Jul 31, 2009
Key facts
- NPI
- 1457582991
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- D-992 (GU)
- Practice address
- 222 Chalan Santo Papa St.
The Reflection Center Ste. 301
Hagatra, GU 96910 - Phone
- (671) 477-6235
- Fax
- (671) 477-6237
- NPI assigned
- Jul 31, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-992 | GU | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Pediatric Dental Center | Pediatric Dentistry | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | D-992 | GU | Yes |
Addresses
Primary practice location
222 Chalan Santo Papa St.
The Reflection Center Ste. 301
Hagatra, GU 96910
Mailing address
222 Chalan Santo Papa St.
The Reflection Center Ste. 301
Hagatra, GU 96910
Phone (671) 477-6235
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.