Basic Information
| Provider Information | |||||||||
| NPI: | 1265537419 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MONTESCLAROS | ||||||||
| FirstName: | ESPERANZA | ||||||||
| MiddleName: | |||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 839 W CONGRESS ST | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857452819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207929890 | ||||||||
| FaxNumber: | 5208849287 | ||||||||
| Practice Location | |||||||||
| Address1: | 4009 N FLOWING WELLS RD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857052404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204080836 | ||||||||
| FaxNumber: | 5202932964 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 4958 | AZ | Y | Dental Providers | Dentist | General Practice |
No ID Information.