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Individual

DR. LEONOR CECILIA VILLALTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
2547 W SPRINGFIELD AVE APT 2, CHAMPAIGN, IL 61821-2821
(217) 552-8503
Mailing address
2547 W SPRINGFIELD AVE APT 2, CHAMPAIGN, IL 61821-2821
(217) 722-4565

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019029681
IL
122300000X
Dentist
57582
CA

Other

Enumeration date
08/28/2008
Last updated
02/10/2015
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