Organization
VILLALTA DENTAL CORPORATION
Active
Other names
The Baby Teeth Studio
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER Y VILLALTA DDS, MPH (PEDIATRIC DENTIST, OWNER)
(707) 228-5974
Entity
Organization
Contact information
Practice address
12555 W JEFFERSON BLVD STE 210, LOS ANGELES, CA 90066-7032
(707) 228-5974
Mailing address
12555 W JEFFERSON BLVD STE 210, LOS ANGELES, CA 90066-7032
(707) 228-5974
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/27/2022
Last updated
12/27/2022
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