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Individual

MICHELANGELO VILLANUEVA ASCALON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RDH

Contact information

Practice address
9124 MILL PARK AVE, TACOMA, WA 98433-2301
(714) 267-9494
Mailing address
9900 LINCOLN BLVD 2ND FLOOR, TACOMA, WA 98431-0001

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1504424991
UNITED STATES ARMY
Enumeration date
04/20/2021
Last updated
04/20/2021
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