Provider Demographics
NPI:1013196914
Name:ESCOBAR, CARLOS (DMD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:ESCOBAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 US HIGHWAY 1 STE 10
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-4411
Mailing Address - Country:US
Mailing Address - Phone:561-622-0301
Mailing Address - Fax:561-622-4625
Practice Address - Street 1:784 US HIGHWAY 1 STE 10
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-4411
Practice Address - Country:US
Practice Address - Phone:561-622-0301
Practice Address - Fax:561-622-4625
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN164901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice