Organization
ESTRADA & ESTRADA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG W.T. ESTRADA DDS (PRESIDENT)
(757) 548-1611
Entity
Organization
Contact information
Practice address
1354 KEMPSVILLE RD, SUITE 101, CHESAPEAKE, VA 23320-1416
(757) 548-1611
(757) 548-1051
Mailing address
1354 KEMPSVILLE RD, SUITE 101, CHESAPEAKE, VA 23320-1416
(757) 548-1611
(757) 548-1051
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
06969
VA
1223G0001X
General Practice Dentistry
Primary
07715
VA
1223G0001X
General Practice Dentistry
10774
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194705111
DENTAL
VA
01
—
1275686511
DENTAL
VA
01
—
1497808737
DENTAL
VA
Enumeration date
10/19/2007
Last updated
10/19/2007
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