Healthcare Provider Details

I. General information

NPI: 1861509119
Provider Name (Legal Business Name): FRANCISCO J ESPINOZA SR. DDS PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 OFFICE PARK BLVD SUITE 112
BRADENTON FL
34203-3443
US

IV. Provider business mailing address

5255 OFFICE PARK BLVD SUITE 112
BRADENTON FL
34203-3443
US

V. Phone/Fax

Practice location:
  • Phone: 941-739-7770
  • Fax: 941-739-7706
Mailing address:
  • Phone: 941-739-7770
  • Fax: 941-739-7706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN14405
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: