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NPI Code Detail

MEDICARE: DR. LETICIA CASTANEDA ESCOBAR DDS

MEDICARE:  DR. LETICIA  CASTANEDA ESCOBAR  DDS
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
11223G0001XGeneral Practice Dentistry38004TX

General Provider Information

NPI Number : 1376036756
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LETICIA CASTANEDA ESCOBAR DDS
Provider Business Mailing Address
First Line : 2702 S BUCKNER BLVD STE 110
Second Line :
City : DALLAS
State : TX
Zip : 75227-6903
Country : US
Telephone Number : 469-879-5498
Fax Number :
Provider Business Practice Location Address
First Line : 2428 W ILLINOIS AVE
Second Line :
City : DALLAS
State : TX
Zip : 75233-1106
Country : US
Telephone Number : 214-330-0222
Fax Number : 214-330-0317
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2018
Last Update Date : 06/15/2021

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Directions to “ DR. LETICIA CASTANEDA ESCOBAR DDS” Practice Location

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