Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | D7953 | OR |
NPI | 1114098365 |
---|---|
Provider Name | Dr. John E Villano |
First Address | Eugene, OR 97405-2890 |
Second Address | Eugene, OR 97405-2890 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U 88775 | (02) | OR |