| NPI | 1992293443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESUS A VILLEGAS Dentist 203-876-9965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 8668) |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2018-04-30 |