Provider Demographics
NPI:1457789455
Name:MA. CRISTINA ESGUERRA MANIEGO DMD,PC
Entity type:Organization
Organization Name:MA. CRISTINA ESGUERRA MANIEGO DMD,PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA CRISTINA
Authorized Official - Middle Name:ESGUERRA
Authorized Official - Last Name:MANIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:916-772-6777
Mailing Address - Street 1:508 GIBSON DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5794
Mailing Address - Country:US
Mailing Address - Phone:916-772-6777
Mailing Address - Fax:916-789-0333
Practice Address - Street 1:508 GIBSON DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5794
Practice Address - Country:US
Practice Address - Phone:916-772-6777
Practice Address - Fax:916-789-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty