Organization
ESTRELLA EAR, NOSE AND THROAT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHON J WIGGENHORN DO (PRESIDENT)
(623) 535-8770
Entity
Organization
Contact information
Practice address
2700 N 140TH AVE, STE 107, GILBERT, AZ 85395
(623) 535-8770
(623) 535-8771
Mailing address
PO BOX 12250, BELFAST, ME 04915-4013
(623) 535-8770
(623) 535-8771
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497110
—
AZ
Enumeration date
02/15/2010
Last updated
10/18/2013
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