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NPI Code Detail

MEDICARE: ERNESTO ALENIADO SOBERANO

MEDICARE: ERNESTO ALENIADO SOBERANO
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
1124Q00000XDental Hygienist7404NC

General Provider Information

NPI Number : 1659464055
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERNESTO ALENIADO SOBERANO
Provider Business Mailing Address
First Line : 301 PRESTON RD
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28540-5656
Country : US
Telephone Number : 757-444-8654
Fax Number :
Provider Business Practice Location Address
First Line : 301 PRESTON RD
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28540-5656
Country : US
Telephone Number : 757-444-8654
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2006
Last Update Date : 07/08/2007

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Directions to “ ERNESTO ALENIADO SOBERANO ” Practice Location

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