Provider Demographics
NPI:1659507440
Name:VILLEGAS, GLORIA ESTELLA (DDS)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:ESTELLA
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 W LA HABRA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-5307
Mailing Address - Country:US
Mailing Address - Phone:562-905-2552
Mailing Address - Fax:562-905-2772
Practice Address - Street 1:545 W LA HABRA BLVD
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-5307
Practice Address - Country:US
Practice Address - Phone:562-905-2552
Practice Address - Fax:562-905-2772
Is Sole Proprietor?:No
Enumeration Date:2009-06-07
Last Update Date:2009-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58271122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist