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General NPI Number Information
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NPI Number | 1467657437
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Entity Type | Individual
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Provider Name | MA AILEEN VILLARIN BALCE DDS
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Gender | Female
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 06/29/2011
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Provider Practice Location Address
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Address Line | 2041 EL CAMINO REAL
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City | SANTA CLARA
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State | CA
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Zip | 95050-4054
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Country | US
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Telephone | 408-985-8284
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Fax | 408-243-8865
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Provider Business Mailing Address
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Address Line | 2041 EL CAMINO REAL
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City | SANTA CLARA
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State | CA
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Zip | 95050
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Country | US
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Telephone | 408-985-8284
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Fax | 408-243-8865
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 43896
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License Number State | CA
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