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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
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 43740