Organization
JOSE VILLA DDS PC
Active
Other names
Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRUSELA F. VILLA (GENERALIST/ASSISTANT BOOKKEEPER)
(773) 458-4443
Entity
Organization
Contact information
Practice address
2841 GRAND AVE, WAUKEGAN, IL 60085-2372
(847) 360-1610
(847) 360-1689
Mailing address
2841 GRAND AVE, WAUKEGAN, IL 60085-2372
(847) 360-1610
(847) 360-1689
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019021973
IL
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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