Provider Demographics
NPI:1659625556
Name:VILLALOBOS, YOLANDA M (DDS)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:M
Last Name:VILLALOBOS
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 1:8346 COLT LANE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907
Mailing Address - Country:US
Mailing Address - Phone:915-841-7292
Mailing Address - Fax:915-855-2371
Practice Address - Street 1:EJERCITO NACIONAL #8140-B LOCAL 6
Practice Address - Street 2:C
Practice Address - City:CD. JUAREZ
Practice Address - State:CHIHUAHUA
Practice Address - Zip Code:32618
Practice Address - Country:MX
Practice Address - Phone:915-841-7292
Practice Address - Fax:915-855-2371
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ50436511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice