Provider Demographics
NPI:1063638195
Name:ESTAVILLO, NGOC-OANH NGO (DDS)
Entity type:Individual
Prefix:DR
First Name:NGOC-OANH
Middle Name:NGO
Last Name:ESTAVILLO
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 1:39885 ALTA MURRIETA DR
Mailing Address - Street 2:SUITE D-4
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-5438
Mailing Address - Country:US
Mailing Address - Phone:951-304-7560
Mailing Address - Fax:951-696-7780
Practice Address - Street 1:39885 ALTA MURRIETA DR
Practice Address - Street 2:SUITE D-4
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-5438
Practice Address - Country:US
Practice Address - Phone:951-304-7560
Practice Address - Fax:951-696-7780
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA479661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice