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Demitri Villarreal, DDS;MS
Periodontist in Lackland Afb, Texas
NPI 1588865943

Demitri Villarreal is a Periodontist based in Lackland Afb, TX and is specialized in Periodontics. Demitri Villarreal practices in Lackland Afb, TX and has the professional credentials of DDS;MS. The NPI Number for Demitri Villarreal is 1588865943 and holds a License No. A000986496 (Texas).

The current practice location address for Demitri Villarreal is 2133 Pepperrell St, Lackland Afb, TX and can be reached out via phone at 210-292-2558.

Location: 2133 Pepperrell St, Lackland Afb, TX, 78236-5313
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1588865943
Provider Name
Demitri Villarreal
Credential
DDS;MS
Provider Entity Type
Individual
Gender
Male
Address
2133 Pepperrell St, Lackland Afb, TX, 78236-5313
Phone Number
210-292-2558
Fax Number
Provider Enumeration Date
05/31/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2133 Pepperrell St
City
Lackland Afb
State
Texas
Zip
78236-5313
Phone Number
210-292-2558
Fax Number
person
Provider Business Mailing Address Details
Address
2133 Pepperrell St
City
Lackland Afb
State
Texas
Zip
78236-5313
Phone Number
210-292-2558
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Periodontics
Taxonomy
1223P0300X
License No.
23464 (Texas)
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
A000986496 (Texas)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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