Provider Demographics
NPI:1134233505
Name:ESTRELLA, VANESSA (DMD)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:
Last Name:ESTRELLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CALLE JUAN C BORBON
Mailing Address - Street 2:SUITE 71
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5374
Mailing Address - Country:US
Mailing Address - Phone:787-708-1165
Mailing Address - Fax:787-708-1185
Practice Address - Street 1:35 CALLE JUAN C BORBON
Practice Address - Street 2:SUITE 71
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5374
Practice Address - Country:US
Practice Address - Phone:787-708-1165
Practice Address - Fax:787-708-1185
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice