| NPI | 1992456560 |
|---|---|
| Doing Business As | RENOVA DENTAL AND IMPLANT CENTER |
| Entity Type | Organization |
| Authorized Contact | CARLOS F VILLANUEVA Dentist/Manager 754-215-4704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2022-01-14 |