Provider Demographics
NPI:1851424501
Name:ESPIRITU, MARIA ELOISA B (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA ELOISA
Middle Name:B
Last Name:ESPIRITU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARIA ELOISA
Other - Middle Name:B
Other - Last Name:ESPIRITU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:4035 SHADYBROOK COURT
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746
Mailing Address - Country:US
Mailing Address - Phone:916-791-2748
Mailing Address - Fax:916-791-2748
Practice Address - Street 1:2295 FIELDSTONE DRIVE
Practice Address - Street 2:SUITE 240
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648
Practice Address - Country:US
Practice Address - Phone:916-543-8800
Practice Address - Fax:916-543-8950
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA501371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice