MEDICARE: DR. VANESSA ESTRELLA D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1811	PR

General Provider Information

NPI Number	:	1134233505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VANESSA ESTRELLA D.M.D

Provider Business Mailing Address
First Line	:	35 CALLE JUAN C BORBON
Second Line	:	SUITE 71
City	:	GUAYNABO
State	:	PR
Zip	:	00969-5374
Country	:	US
Telephone Number	:	787-708-1165
Fax Number	:	787-708-1185

Provider Business Practice Location Address
First Line	:	35 CALLE JUAN C BORBON
Second Line	:	SUITE 71
City	:	GUAYNABO
State	:	PR
Zip	:	00969-5374
Country	:	US
Telephone Number	:	787-708-1165
Fax Number	:	787-708-1185

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	07/08/2007

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