Provider Demographics
NPI:1225248610
Name:SANDRA J ALJURE ESTRADA DDS PA
Entity Type:Organization
Organization Name:SANDRA J ALJURE ESTRADA DDS PA
Other - Org Name:LAND O LAKES DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALJURE ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PA
Authorized Official - Phone:813-949-7424
Mailing Address - Street 1:21533 VILLAGES LAKES SHOPPING CENTER
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639
Mailing Address - Country:US
Mailing Address - Phone:813-949-7424
Mailing Address - Fax:813-949-7426
Practice Address - Street 1:21533 VILLAGES LAKES SHOPPING CENTER
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639
Practice Address - Country:US
Practice Address - Phone:813-949-7424
Practice Address - Fax:813-949-7426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL150911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty