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General NPI Number Information
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NPI Number | 1255255097
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Entity Type | Individual
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Provider Name | MARCOS ANTONIO ESQUIVEL CARDOSO DDS
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Gender | Male
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 25501 BRAINARD AVE
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City | FORT GORDON
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State | GA
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Zip | 30905
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Country | US
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Telephone | 706-787-7050
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Fax |
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Provider Business Mailing Address
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Address Line | 403 FURYS FERRY RD STE 100 #167
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City | MARTINEZ
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State | GA
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Zip | 30907-8222
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 113127
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License Number State | CA
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