Organization
JOSE VILLA PC
Active
Other names
family dental care
Organization subpart
No
Provider details
NPI number
Authorized official
KEIKO VILLA (RECEPTIONIST)
(773) 528-0068
Entity
Organization
Contact information
Practice address
1426 W BELMONT AVE, #1, CHICAGO, IL 60657-6898
(773) 528-0068
Mailing address
1426 W BELMONT AVE, 1426 W BELMONT AVE, CHICAGO, IL 60657-6898
(773) 528-0068
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
201902173
IL
Other
Enumeration date
10/17/2008
Last updated
10/17/2008
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