Provider Demographics
NPI:1841618162
Name:ESTELLE, ABIGAIL ELISABETH (MBBS, BDS, MRCS)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:ELISABETH
Last Name:ESTELLE
Suffix:
Gender:F
Credentials:MBBS, BDS, MRCS
Other - Prefix:DR
Other - First Name:ABIGAIL
Other - Middle Name:ELISABETH
Other - Last Name:BOYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS, MRCS
Mailing Address - Street 1:3994 W TRAILS END
Mailing Address - Street 2:
Mailing Address - City:ELFRIDA
Mailing Address - State:AZ
Mailing Address - Zip Code:85610-9140
Mailing Address - Country:US
Mailing Address - Phone:520-642-1111
Mailing Address - Fax:
Practice Address - Street 1:653-1 W 8TH ST
Practice Address - Street 2:2ND FL/LRC
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-3689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program