Provider Demographics
NPI:1184780959
Name:ESLAO, KATHERINE C (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:C
Last Name:ESLAO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 LYON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-3226
Mailing Address - Country:US
Mailing Address - Phone:415-921-1726
Mailing Address - Fax:415-346-5798
Practice Address - Street 1:2920 LYON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-3226
Practice Address - Country:US
Practice Address - Phone:415-921-1726
Practice Address - Fax:415-346-5798
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA424661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice