Provider Demographics
NPI:1952025090
Name:DR PATRICE ESPINOSA DDS PC
Entity Type:Organization
Organization Name:DR PATRICE ESPINOSA DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-892-6969
Mailing Address - Street 1:1223 GRANT AVE
Mailing Address - Street 2:SUITE #A
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-3157
Mailing Address - Country:US
Mailing Address - Phone:415-892-6969
Mailing Address - Fax:415-898-6364
Practice Address - Street 1:1223 GRANT AVE
Practice Address - Street 2:SUITE #A
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-3157
Practice Address - Country:US
Practice Address - Phone:415-892-6969
Practice Address - Fax:415-898-6364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty