Provider Demographics
NPI:1902020506
Name:VILLANUEVA CABANSAG, NANCY (DDS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:VILLANUEVA CABANSAG
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 1:5519 VICKSBURG DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5988
Mailing Address - Country:US
Mailing Address - Phone:817-478-1826
Mailing Address - Fax:
Practice Address - Street 1:699 NE ALSBURY BLVD
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-2660
Practice Address - Country:US
Practice Address - Phone:817-295-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20693122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist