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Organization
RAFAEL VILLACORTA FAMILY DENTISTRY
Active
Organization
RAFAEL VILLACORTA FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL E VILLACORTA DMD (PRESIDENT)
(781) 891-5637
Entity
Organization
Contact information
Practice address
24 CRESCENT ST, SUITE 303, WALTHAM, MA 02453-4358
(781) 891-5637
(781) 891-8925
Mailing address
24 CRESCENT ST, SUITE 303, WALTHAM, MA 02453-4358
(781) 891-5637
(781) 891-8925
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
18063
MA
Other
Enumeration date
03/21/2008
Last updated
03/21/2008
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