Jose Villa DDS PC

NPI #1053706481 in Waukegan, Illinois

Provider Information

NPI Number: 1053706481
Entity Type: Organization
Organization Name: Jose Villa DDS PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 2, 2015
Last Updated: Apr 2, 2015

Practice Location

Address: 2841 GRAND AVE
City: Waukegan
State: Illinois
ZIP Code: 60085-2372
Phone: (847) 360-1610

Authorized Official

Name: MS. BRUSELA F. VILLA
Title: GENERALIST/ASSISTANT BOOKKEEPER
Phone: (773) 458-4443

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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