Organization
CHANDLER KIDIATRIC DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER VILLANUEVA DDS (OWNER AND DENTIST)
(480) 398-1372
Entity
Organization
Contact information
Practice address
224 W CHANDLER HEIGHTS RD, CHANDLER, AZ 85248-5072
(480) 398-1372
(480) 398-1373
Mailing address
224 W CHANDLER HEIGHTS RD, CHANDLER, AZ 85248-5072
(480) 398-1372
(480) 398-1373
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D07782
AZ
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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