Elisabeth Estep

Individual provider Active NPI General Practice Dentistry · Whiteman Afb, MO

NPI 1497459846 · NPPES record last updated Dec 10, 2024

Key facts

NPI
1497459846
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
016.0134194 (VT)
Practice address
331 Sijen Ave
Whiteman Afb, MO 65305-1269
Phone
(660) 687-2188
NPI assigned
Mar 29, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
016.0134194VTMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 016.0134194 VT Yes

Addresses

Primary practice location

331 Sijen Ave
Whiteman Afb, MO 65305-1269

Mailing address

331 Sijen Ave
Whiteman Afb, MO 65305-1269

Other providers in Whiteman Afb, MO

All providers in Whiteman Afb, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.