| NPI | 1811145857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESUS A VILLEGAS Member/Dentist 203-783-9994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| 1223G0001X Dentist, General Practice | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2014-06-24 |