Provider Demographics
NPI:1326019837
Name:ESQUIBEL, MITCHELL DUANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:DUANE
Last Name:ESQUIBEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:1016 S BISHOP AVE
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-4416
Mailing Address - Country:US
Mailing Address - Phone:573-341-3383
Mailing Address - Fax:573-341-3485
Practice Address - Street 1:1016 S BISHOP AVE
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-4416
Practice Address - Country:US
Practice Address - Phone:573-341-3383
Practice Address - Fax:573-341-3485
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MODE0140171223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology