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NPI Code Detail

MEDICARE: ESTELA DENTAL INC.

MEDICARE: ESTELA DENTAL INC.
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 DentistryDN12654FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861765141
Entity Type Code : Organization
Provider Name (Legal Business Name) : ESTELA DENTAL INC.
Provider Business Mailing Address
First Line : 6336 FOREST HILL BLVD
Second Line :
City : GREENACRES
State : FL
Zip : 33415-6104
Country : US
Telephone Number : 561-642-1177
Fax Number : 561-642-1143
Provider Business Practice Location Address
First Line : 6336 FOREST HILL BLVD
Second Line :
City : GREENACRES
State : FL
Zip : 33415-6104
Country : US
Telephone Number : 561-642-1177
Fax Number : 561-642-1143
Authorized Official
Title or Position : DENTIST
Name : DR. HILDEBRANDO BARRETO
Credential : DDS
Telephone Number : 561-642-1177
Provider Enumeration Date : 02/16/2012
Last Update Date : 02/16/2012

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