Organization
FAIRFIELD PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESUS A VILLEGAS (MEMBER/DENTIST)
(203) 783-9994
Entity
Organization
Contact information
Practice address
209 BOSTON POST RD, SUITE 201, MILFORD, CT 06460-3161
(203) 783-9994
(203) 783-9961
Mailing address
209 BOSTON POST RD, SUITE 201, MILFORD, CT 06460-3161
(203) 783-9994
(203) 783-9961
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
09/03/2008
Last updated
06/24/2014
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