Individual
DENISE EBALO VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
995 MONTAGUE EXPY STE 210, MILPITAS, CA 95035-6885
(408) 946-5858
Mailing address
1828 SADDLE PARK AVE, SAN JOSE, CA 95138-2768
(408) 688-6375
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
106937
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2020
Last updated
09/09/2021
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