Provider Demographics
NPI:1255392478
Name:ESPIRITO SANTO, ANDREA HADDAD (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:HADDAD
Last Name:ESPIRITO SANTO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MARQUES
Other - Last Name:HADDAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16235 STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2736
Mailing Address - Country:US
Mailing Address - Phone:561-637-4443
Mailing Address - Fax:561-637-4428
Practice Address - Street 1:16235 STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2736
Practice Address - Country:US
Practice Address - Phone:561-637-4428
Practice Address - Fax:561-637-4428
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL158181223G0001X
FLDN158181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice