Provider Demographics
NPI:1386115293
Name:LUZ E. ESTRADA, DDS, PLLC II
Entity type:Organization
Organization Name:LUZ E. ESTRADA, DDS, PLLC II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-900-0252
Mailing Address - Street 1:300 ASHVILLE AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8694
Mailing Address - Country:US
Mailing Address - Phone:919-852-1811
Mailing Address - Fax:
Practice Address - Street 1:300 ASHVILLE AVE STE 270
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8694
Practice Address - Country:US
Practice Address - Phone:919-852-1811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty