Provider Demographics
NPI:1104983758
Name:MANIEGO, MARIA CRISTINA ESGUERRA (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIA CRISTINA
Middle Name:ESGUERRA
Last Name:MANIEGO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MA. CRISTINA
Other - Middle Name:ESGUERRA
Other - Last Name:MANIEGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:508 GIBSON DR
Mailing Address - Street 2:STE 100
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5794
Mailing Address - Country:US
Mailing Address - Phone:916-412-5468
Mailing Address - Fax:
Practice Address - Street 1:508 GIBSON DR
Practice Address - Street 2:STE 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
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice