Provider Demographics
NPI:1851323893
Name:ESTRELLA-GEMBA, ALICE C (DDS)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:C
Last Name:ESTRELLA-GEMBA
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 1:435 N STATE COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-2917
Mailing Address - Country:US
Mailing Address - Phone:714-772-6540
Mailing Address - Fax:714-772-6555
Practice Address - Street 1:435 N STATE COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-2917
Practice Address - Country:US
Practice Address - Phone:714-772-6540
Practice Address - Fax:714-772-6540
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA379561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice