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General NPI Number Information
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NPI Number | 1548782600
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Entity Type | Individual
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Provider Name | EMMY ESTENOZ
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Gender | Female
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Dates
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Enumeration Date | 07/11/2017
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 4825 COCONUT CREEK PKWY
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City | COCONUT CREEK
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State | FL
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Zip | 33063-3944
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Country | US
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Telephone | 954-642-2203
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Fax | 954-532-2202
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Provider Business Mailing Address
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Address Line | 3105 BLACK OAK CT
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-6605
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Country | US
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Telephone | 786-325-5761
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN22716
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License Number State | FL
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