Provider Demographics
NPI:1265943138
Name:MARCANTEL, ESMERALDA DIAZ (DDS)
Entity type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:DIAZ
Last Name:MARCANTEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6215 ROSEHILL HARVEST LOOP
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493
Mailing Address - Country:US
Mailing Address - Phone:713-501-5167
Mailing Address - Fax:
Practice Address - Street 1:4540 SPRING STUEBNER RD SUITE 500
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77022-1624
Practice Address - Country:US
Practice Address - Phone:713-692-1388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-19
Last Update Date:2023-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX396351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice