| NPI | 1629713979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALESSANDRO VILLA Owner 339-226-2744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 122300000X Dentist |
| 125Q00000X Oral Medicinist | |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2024-02-26 |