Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

San Juan Oral & Facial Surgery

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1104228329

San Juan Oral & Facial Surgery is an Oral and Maxillofacial Surgery (Dentist) in Farmington, New Mexico. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

2990 E Pinon Frontage Rd Ste 102
Farmington, NM 87402-5068
Phone: (505) 333-8635
Fax: (505) 258-4909
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X

Record details

NPI number1104228329
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Beverly Bradford — Office Manager · (505) 333-8635
NPI enumeratedSeptember 18, 2014
Last updated in NPPESMarch 3, 2021
Certification dateMarch 3, 2021
Mailing address2990 E Pinon Frontage Rd Ste 102, Farmington, NM 87402-5068

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