Individual
MS. DIANA MARIA VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1655 ELMWOOD AVE STE 215, ROCHESTER, NY 14620-3426
(585) 636-0555
Mailing address
1655 ELMWOOD AVE STE 215, ROCHESTER, NY 14620-3426
(585) 636-0555
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
062615
NY
1223G0001X
General Practice Dentistry
Primary
062615
NY
1223G0001X
General Practice Dentistry
3418
PR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2021
Last updated
08/29/2022
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