Provider Demographics
NPI:1730410051
Name:ESTRADA, ROSA MARIA (DDS)
Entity type:Individual
Prefix:DR
First Name:ROSA
Middle Name:MARIA
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24930 CALLE EL ROSARIO
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93908-9532
Mailing Address - Country:US
Mailing Address - Phone:831-206-9858
Mailing Address - Fax:
Practice Address - Street 1:24930 CALLE EL ROSARIO
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93908-9532
Practice Address - Country:US
Practice Address - Phone:831-206-9858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA585251223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice