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General NPI Number Information
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NPI Number | 1588757470
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Entity Type | Organization
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Legal Business Name | SOUTH COURT DENTAL MEDICINE, INC. -JEFFREY C ESTERBURG D.M.D. AND MICH
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1063 S COURT ST
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City | MEDINA
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State | OH
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Zip | 44256-2824
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Country | US
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Telephone | 330-725-0581
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Fax | 330-722-0146
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Provider Business Mailing Address
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Address Line | 1063 S COURT ST
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City | MEDINA
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State | OH
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Zip | 44256-2824
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Country | US
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Telephone | 330-725-0581
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Fax | 330-722-0146
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY C ESTERBURG
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Credential | D.M.D.
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Telephone | 330-725-0581
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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 |
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License Number State |
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