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Organization
VILLAZ DENTAL PC
Active
Organization
VILLAZ DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NISHU SHARMA (PRESIDENT)
(630) 530-9000
Entity
Organization
Contact information
Practice address
298 W NORTH AVE, VILLA PARK, IL 60181-1159
(630) 530-9000
Mailing address
298 W NORTH AVE, VILLA PARK, IL 60181-1159
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028703
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063709186
INDIVIDUAL NPI
IL
Enumeration date
10/19/2016
Last updated
10/19/2016
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