Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 011665 | GA |
NPI | 1164537403 |
---|---|
Provider Name | Dr. Estelle F. Zandstra |
First Address | Alpharetta, GA 30005 |
Second Address | Alpharetta, GA 30005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 22/05/2020 |