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Provider Information for 1053518472



DR. THERESA EUSEBIO VILLANO D.D.S.

Gender: FEMALE

Individual NPI: 1053518472

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1053518472
Enumeration Date 2007-06-29
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 2161 YGNACIO VALLEY RD #110
WALNUT CREEK, CA 94598-3396
United States

Phone: 925-937-2273 | Fax:
View Map External Link
Primary Practice Address 2161 YGNACIO VALLEY RD
WALNUT CREEK, CA 94598-3396
United States

Phone: 925-937-2273 | Fax: 925-937-9337
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 43740
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location