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NPI Code Detail

MEDICARE: DR. GLORIA ENIBETTE ESTRADA DMD

MEDICARE: DR. GLORIA ENIBETTE ESTRADA DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist8646NC
21223G0001XGeneral Practice Dentistry2803PR
31223G0001XGeneral Practice Dentistry8646NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336318922
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLORIA ENIBETTE ESTRADA DMD
Provider Business Mailing Address
First Line : 7 PROFESSIONAL DR
Second Line :
City : SNOW HILL
State : NC
Zip : 28580-1332
Country : US
Telephone Number : 252-747-8162
Fax Number :
Provider Business Practice Location Address
First Line : 6 PROFESSIONAL DR
Second Line :
City : SNOW HILL
State : NC
Zip : 28580-1333
Country : US
Telephone Number : 252-747-3846
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2008
Last Update Date : 02/01/2023

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