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NPI 1609051721

NPI 1609051721 : ADALBERTO ESQUIVEL JR DDS INC : MISSION, TX

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General NPI Number Information
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    NPI Number           |    1609051721
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    Entity Type          |    Organization 
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    Legal Business Name  |    ADALBERTO ESQUIVEL JR DDS INC 
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Dates
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    Enumeration Date     |    01/08/2008
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    Last Update Date     |    01/08/2008
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Provider Practice Location Address
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    Address Line         |    1501 N BRYAN RD 
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    City                 |    MISSION
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    State                |    TX
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    Zip                  |    78572-4348
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    Country              |    US
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    Telephone            |    956-585-1629
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    Fax                  |    956-585-1611
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Provider Business Mailing Address
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    Address Line         |    1501 N BRYAN RD 
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    City                 |    MISSION
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    State                |    TX
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    Zip                  |    78572-4348
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    Country              |    US
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    Telephone            |    956-585-1629
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    Fax                  |    956-585-1611
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Authorized Official
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    Title or Position    |    DENTIST
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    Name                 |    DR. ADALBERTO  ESQUIVEL JR.
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    Credential           |    D.D.S.
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    Telephone            |    956-585-1629
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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       |    12003
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    License Number State |    TX
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