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General NPI Number Information
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NPI Number | 1255860706
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Entity Type | Individual
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Provider Name | RUBEN VILLARREAL DMD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 2910 N STATE ROAD 7
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-1912
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Country | US
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Telephone | 954-533-9639
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Fax |
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Provider Business Mailing Address
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Address Line | 17631 SW 4TH CT
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-4016
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Country | US
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Telephone | 305-746-9841
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN22675
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License Number State | FL
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