Individual
DR. JUAN VILLASIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1354 KEMPSVILLE RD, SUITE 101, CHESAPEAKE, VA 23320-1416
(757) 548-1051
Mailing address
1204 JAMAICA AVE, CHESAPEAKE, VA 23322-6928
(757) 560-1845
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410774
VA
Other
Enumeration date
01/17/2006
Last updated
07/08/2007
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