Provider Demographics
NPI:1437297439
Name:CONSTABLE-BERESFORD, ESTELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ESTELLE
Middle Name:
Last Name:CONSTABLE-BERESFORD
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 1:1850 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6064
Mailing Address - Country:US
Mailing Address - Phone:561-642-8501
Mailing Address - Fax:561-642-4991
Practice Address - Street 1:1850 FOREST HILL BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6064
Practice Address - Country:US
Practice Address - Phone:561-642-8501
Practice Address - Fax:561-642-4991
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN161441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice