Provider Demographics
NPI:1437203288
Name:QUAILE- UY, MARLYN ESTOLANO (D)
Entity Type:Individual
Prefix:DR
First Name:MARLYN
Middle Name:ESTOLANO
Last Name:QUAILE- UY
Suffix:
Gender:F
Credentials:D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1474 N MILPITAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-3118
Mailing Address - Country:US
Mailing Address - Phone:408-262-5762
Mailing Address - Fax:408-262-1337
Practice Address - Street 1:1474 N MILPITAS BLVD
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-3118
Practice Address - Country:US
Practice Address - Phone:408-262-5762
Practice Address - Fax:408-262-1337
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39872122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist