Provider Demographics
NPI:1467657437
Name:BALCE, MA AILEEN VILLARIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MA AILEEN
Middle Name:VILLARIN
Last Name:BALCE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARIA AILEEN
Other - Middle Name:VILLARIN
Other - Last Name:BALCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2041 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050
Mailing Address - Country:US
Mailing Address - Phone:408-985-8284
Mailing Address - Fax:408-243-8865
Practice Address - Street 1:2041 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4054
Practice Address - Country:US
Practice Address - Phone:408-985-8284
Practice Address - Fax:408-243-8865
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice