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1528644960
DANIEL RENE VILLELA
GROTON, CT
NPI
1528644960
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2021-03-23
Last Update Date
2021-03-23
Business Address
DANIEL RENE VILLELA Submarine IDC
166 ARROWOOD DR
GROTON, CT 06340-2509
Phone number: 912-506-8705
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Mailing Address
DANIEL RENE VILLELA Submarine IDC
166 ARROWOOD DR
GROTON, CT 06340-2509
Phone number: 912-506-8705
Copy
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