Individual
DR. JUSTIN VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MSD, DHL
Contact information
Practice address
7546 JANES AVE, WOODRIDGE, IL 60517-2926
(630) 985-9787
Mailing address
415 N 26TH ST STE 303, LAFAYETTE, IN 47904-2893
(765) 447-9319
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019030729
IL
1223P0300X
Periodontics
Primary
12013130A
IN
Other
Enumeration date
07/25/2016
Last updated
01/29/2021
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